Crack lung

Case contributed by Dr Mahomed A. Osman

Presentation

IVDU, hepatitis B, hepatitis C, and history of cocaine smoking. Query pulmonary hemorrhage?

Patient Data

Gender: Male
X-ray

The ETT is at the carina. NGT tube tip not visualised well. Diffuse bilateral perihilar consolidation with air bronchograms. 

CT

Bilateral confluent basal consolidation (air bronchograms visible) with ill-defined/nodular consolidation in the upper lobes.

Case Discussion

Clinical-radiologic correlation suggest that DAD/pulmonary hemorrhage was the two most likely finding however, infection and aspiration is also a consideration. Please note all of the above can be associated cocaine/illicit drug use. There are no specific imaging features for ilicit drug use, but a strong suspicion is placed when an young adult present with diffuse lung disease without an apparent cause. Subsequent pulmonary wedge biopsy, which showed an eosinophilic infiltrate. consistent with crack cocaine smoking.

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Case information

rID: 22206
Case created: 20th Mar 2013
Last edited: 8th Nov 2015
System: Chest
Inclusion in quiz mode: Included

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