Acute pulmonary toxicity from crack cocaine: Difference between revisions

 
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==Background==
==Background==
[[File:Rocks of crack cocaine.jpg|thumb|"Rocks" of crack [[cocaine]]]]
[[File:Lung and diaphragm.jpg|thumb|Lobes of the lung with related anatomy.]]
*Also known as "crack lung"
*Also known as "crack lung"
*Due to hemorrhagic alveolitis from inhalational cocaine use <ref>Forrester JM. Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. Am Rev Respir Dis. 1990;142(2):462-7.</ref>
*Usually presents within 48 hours of crack cocaine inhalation.
*Due to hemorrhagic alveolitis from inhalational crack cocaine use <ref>Forrester JM. Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. Am Rev Respir Dis. 1990;142(2):462-7.</ref>
**Crack cocaine vaporizes at 187°C<ref name="Devlin" />


==Clinical Features==
==Clinical Features==
*Most common symptoms are cough and shortness of breath
*Characterized by [[dyspnea]] and [[hypoxia]] after crack cocaine use<ref name="Devlin">Devlin RJ, Henry JA. Clinical review: Major consequences of illicit drug consumption. Critical Care. 2008;12(1):202. doi:10.1186/cc6166.</ref>
*Others include:  
*May also see:  
**acute lung injury
**[[Fever]]
**[[hypoxia]]
**[[Hemoptysis]]
**[[chest pain]]
**[[Respiratory failure]]
**[[hemoptysis]]
**[[Pulmonary edema]]
**[[fever]]
**focal infiltrates
**bronchospasm


==Differential Diagnosis==
==Differential Diagnosis==
*Acute pulmonary toxicity from crack cocaine (Crack lung)
*[[Acute eosinophilic pneumonia]]
*[[Acute eosinophilic pneumonia]]
*[[Acute respiratory distress syndrome]]
*[[Acute respiratory distress syndrome]]
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*[[Acute coronary syndrome]]
*[[Acute coronary syndrome]]
*[[Pneumothorax]]
*[[Pneumothorax]]
*Subcutaneous emphysema / [[pneumomediastinum]]
*Subcutaneous emphysema/[[pneumomediastinum]]
 
{{Drugs of abuse types}}


==Evaluation==
==Evaluation==
*CXR
*Generally a clinical diagnosis
*May have eosinophilia, which suggests an immune mediated component<ref>Kissner DG.Crack lung: pulmonary disease caused by cocaine abuse. Am Rev Respir Dis. 1987;136(5):1250-2.</ref>
*Consider [[CXR]] and labs
**May have [[eosinophilia]], which suggests an immune mediated component<ref>Kissner DG.Crack lung: pulmonary disease caused by cocaine abuse. Am Rev Respir Dis. 1987;136(5):1250-2.</ref>


==Management==
==Management==
*Supportive care, maintain oxygenation and ventilation
*Supportive care
*Systemic [[corticosteroids]]<ref name="Devlin" />
 
==Disposition==
==Disposition==
*Admit


==See Also==
==See Also==
*[[Cocaine]]
*[[Cocaine]]
*[[Cocaine toxicity]]
*[[Cocaine toxicity]]
*[[Cocaine Withdrawal]]  
*[[Cocaine withdrawal]]
*[[Drugs of abuse]]
 
==External Links==
==External Links==


==References==
==References==
<references/>
<references/>


[[Category:Pulmonary]] [[Category:Toxicology]]
[[Category:Pulmonary]]
[[Category:Toxicology]]

Latest revision as of 18:20, 29 July 2025

Background

"Rocks" of crack cocaine
Lobes of the lung with related anatomy.
  • Also known as "crack lung"
  • Usually presents within 48 hours of crack cocaine inhalation.
  • Due to hemorrhagic alveolitis from inhalational crack cocaine use [1]
    • Crack cocaine vaporizes at 187°C[2]

Clinical Features

Differential Diagnosis

Drugs of abuse

Evaluation

  • Generally a clinical diagnosis
  • Consider CXR and labs

Management

Disposition

  • Admit

See Also

External Links

References

  1. Forrester JM. Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. Am Rev Respir Dis. 1990;142(2):462-7.
  2. 2.0 2.1 2.2 Devlin RJ, Henry JA. Clinical review: Major consequences of illicit drug consumption. Critical Care. 2008;12(1):202. doi:10.1186/cc6166.
  3. Kissner DG.Crack lung: pulmonary disease caused by cocaine abuse. Am Rev Respir Dis. 1987;136(5):1250-2.