Interstitial lung damage due to cocaine abuse

Abstract

Introduction. A case report of a male patient who was diagnosed with interstitial lung disease due to illicit stimulants abuse. Case Description. A 33-year-old man was found sleeping breathlessly. Resuscitation was initiated by his girlfriend until the paramedics arrived. Naloxone was injected. Signs of respiratory failure began appearing upon arrival at the emergency room. The patient was somnolent through examination, his limbs were cyanotic, saturation was 49 percent. Positive dynamics was observed after another naloxone injection. Toxicology screen had been carried out. Test results were positive for cocaine, amphetamine, 3,4-Methylenedioxymethamphetamine (MDMA), benzodiazepines, and opioids. A chest roentgenogram and a computed tomography scan show altered lung tissue. CT images show infiltration of ground-glass opacity (GGO) predominating in central parts of the lungs in all lobes. The radiograph shows infiltrates of GGO and interstitial edema in all parts of the lungs. Positive dynamics was observed radiologically during the treatment and lung aeration increased on both lungs in chest x-rays performed later. Summary. Illicit stimulants, such as cocaine, amphetamine, and their derivatives (e.g., “ecstasy”), continue to exact heavy toll on health care. Abuse of both inhaled and intravenous forms of these substances can result in a variety of acute and chronic injuries to practically every part of the respiratory tract, leading potentially to permanent morbidities as well as fatal consequences - including but not limited to nasal septum perforation, pulmonary hypertension, pneumothorax, pneumomediastinum, interstitial lung disease, alveolar hemorrhage, reactive airway disease, pulmonary edema, pulmonary granulomatosis, infections, foreign body aspiration, infections, bronchoconstriction, and thermal injuries. Conclusion. In the meantime, health care providers must be aware of the host of respiratory toxidromes-associated stimulant abuse to [...].