Crack lung

Case contributed by Dr Danilo Ferreira Maia

Presentation

Patient alcoholic, smoker, and crack user. presenting with clinical symptoms of dry cough, dyspnea, orthopnea, nocturnal paroxystic dyspnea, chest pain/tightness, prostration, fever, night sweats and chills.

Patient Data

Age: 45 years
Gender: Male

CT Chest

CT

Diffuse bilateral pulmonary involvement due to peribronchovascular and subpleural opacities, predominantly central/perihilar, thickening of interlobular septa, and opacities in ground glass at the apexes configuring mosaic paving patterns. Such changes suggest pulmonary interstitial edema, and in this clinical context, "crack lung".

Case Discussion

Patient evolved with acute respiratory failure, had to be intubated and needed norepinephrine. After advanced clinical support, the patient had improvement in symptoms and was discharged from ICU.

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