Cocaine-Induced Asthma and the "Crack Lung": A Case Report
Cocaine, the second most used illicit drug, is associated with cardiovascular, pulmonary, and other complications. Lung involvement associated with cocaine use, also known as "crack lung syndrome" (CLS), can elicit new-onset and exacerbate chronic pulmonary conditions. A 28-year-old female...
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Published in | Curēus (Palo Alto, CA) Vol. 16; no. 2; p. e53904 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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United States
Springer Nature B.V
09.02.2024
Cureus |
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Online Access | Get full text |
ISSN | 2168-8184 2168-8184 |
DOI | 10.7759/cureus.53904 |
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Abstract | Cocaine, the second most used illicit drug, is associated with cardiovascular, pulmonary, and other complications. Lung involvement associated with cocaine use, also known as "crack lung syndrome" (CLS), can elicit new-onset and exacerbate chronic pulmonary conditions. A 28-year-old female with a history of chronic controlled asthma arrived at the Emergency Department (ED), referring to cocaine inhalation, followed by symptoms compatible with an asthmatic crisis, requiring immediate steroid and bronchodilator therapy. Radiological studies and bronchoscopy confirmed CLS diagnosis. Despite treatment with oxygen, bronchodilators, and steroids, the asthmatic crises persisted. However, after 48 hours, we observed a complete regression of the lung infiltrates. This case highlights the importance of clinical suspicion, bronchoscopy findings, and the potential co-occurrence of CLS with asthma exacerbations. While computed tomography (CT) scans can be helpful, they should not be the only tool to diagnose CLS. The successful management of CLS involves the use of bronchodilators, steroids, and oxygen therapy and abstaining from cocaine use. Researchers should conduct further studies to diagnose and treat CLS in conjunction with acute asthma symptoms to assist this patient population better. |
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AbstractList | Cocaine, the second most used illicit drug, is associated with cardiovascular, pulmonary, and other complications. Lung involvement associated with cocaine use, also known as "crack lung syndrome" (CLS), can elicit new-onset and exacerbate chronic pulmonary conditions. A 28-year-old female with a history of chronic controlled asthma arrived at the Emergency Department (ED), referring to cocaine inhalation, followed by symptoms compatible with an asthmatic crisis, requiring immediate steroid and bronchodilator therapy. Radiological studies and bronchoscopy confirmed CLS diagnosis. Despite treatment with oxygen, bronchodilators, and steroids, the asthmatic crises persisted. However, after 48 hours, we observed a complete regression of the lung infiltrates. This case highlights the importance of clinical suspicion, bronchoscopy findings, and the potential co-occurrence of CLS with asthma exacerbations. While computed tomography (CT) scans can be helpful, they should not be the only tool to diagnose CLS. The successful management of CLS involves the use of bronchodilators, steroids, and oxygen therapy and abstaining from cocaine use. Researchers should conduct further studies to diagnose and treat CLS in conjunction with acute asthma symptoms to assist this patient population better.Cocaine, the second most used illicit drug, is associated with cardiovascular, pulmonary, and other complications. Lung involvement associated with cocaine use, also known as "crack lung syndrome" (CLS), can elicit new-onset and exacerbate chronic pulmonary conditions. A 28-year-old female with a history of chronic controlled asthma arrived at the Emergency Department (ED), referring to cocaine inhalation, followed by symptoms compatible with an asthmatic crisis, requiring immediate steroid and bronchodilator therapy. Radiological studies and bronchoscopy confirmed CLS diagnosis. Despite treatment with oxygen, bronchodilators, and steroids, the asthmatic crises persisted. However, after 48 hours, we observed a complete regression of the lung infiltrates. This case highlights the importance of clinical suspicion, bronchoscopy findings, and the potential co-occurrence of CLS with asthma exacerbations. While computed tomography (CT) scans can be helpful, they should not be the only tool to diagnose CLS. The successful management of CLS involves the use of bronchodilators, steroids, and oxygen therapy and abstaining from cocaine use. Researchers should conduct further studies to diagnose and treat CLS in conjunction with acute asthma symptoms to assist this patient population better. Cocaine, the second most used illicit drug, is associated with cardiovascular, pulmonary, and other complications. Lung involvement associated with cocaine use, also known as "crack lung syndrome" (CLS), can elicit new-onset and exacerbate chronic pulmonary conditions. A 28-year-old female with a history of chronic controlled asthma arrived at the Emergency Department (ED), referring to cocaine inhalation, followed by symptoms compatible with an asthmatic crisis, requiring immediate steroid and bronchodilator therapy. Radiological studies and bronchoscopy confirmed CLS diagnosis. Despite treatment with oxygen, bronchodilators, and steroids, the asthmatic crises persisted. However, after 48 hours, we observed a complete regression of the lung infiltrates.This case highlights the importance of clinical suspicion, bronchoscopy findings, and the potential co-occurrence of CLS with asthma exacerbations. While computed tomography (CT) scans can be helpful, they should not be the only tool to diagnose CLS. The successful management of CLS involves the use of bronchodilators, steroids, and oxygen therapy and abstaining from cocaine use. Researchers should conduct further studies to diagnose and treat CLS in conjunction with acute asthma symptoms to assist this patient population better. Cocaine, the second most used illicit drug, is associated with cardiovascular, pulmonary, and other complications. Lung involvement associated with cocaine use, also known as "crack lung syndrome" (CLS), can elicit new-onset and exacerbate chronic pulmonary conditions. A 28-year-old female with a history of chronic controlled asthma arrived at the Emergency Department (ED), referring to cocaine inhalation, followed by symptoms compatible with an asthmatic crisis, requiring immediate steroid and bronchodilator therapy. Radiological studies and bronchoscopy confirmed CLS diagnosis. Despite treatment with oxygen, bronchodilators, and steroids, the asthmatic crises persisted. However, after 48 hours, we observed a complete regression of the lung infiltrates. This case highlights the importance of clinical suspicion, bronchoscopy findings, and the potential co-occurrence of CLS with asthma exacerbations. While computed tomography (CT) scans can be helpful, they should not be the only tool to diagnose CLS. The successful management of CLS involves the use of bronchodilators, steroids, and oxygen therapy and abstaining from cocaine use. Researchers should conduct further studies to diagnose and treat CLS in conjunction with acute asthma symptoms to assist this patient population better. |
Author | González-Torres, Luis A Alanís-Estrada, Gabriela Moreno-Hoyos-Abril, Juan Francisco Gamboa-Meza, Alan López-Félix, Victor A |
AuthorAffiliation | 2 Pulmonary and Critical Care, Hospital José Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, Monterrey, MEX 1 Internal Medicine, Hospital José Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, Monterrey, MEX |
AuthorAffiliation_xml | – name: 2 Pulmonary and Critical Care, Hospital José Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, Monterrey, MEX – name: 1 Internal Medicine, Hospital José Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, Monterrey, MEX |
Author_xml | – sequence: 1 givenname: Victor A surname: López-Félix fullname: López-Félix, Victor A – sequence: 2 givenname: Luis A surname: González-Torres fullname: González-Torres, Luis A – sequence: 3 givenname: Alan surname: Gamboa-Meza fullname: Gamboa-Meza, Alan – sequence: 4 givenname: Gabriela surname: Alanís-Estrada fullname: Alanís-Estrada, Gabriela – sequence: 5 givenname: Juan Francisco surname: Moreno-Hoyos-Abril fullname: Moreno-Hoyos-Abril, Juan Francisco |
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Keywords | persistent bronchospasm crack lung syndrome cocaine ingestion acute asthma exacerbation crack lung |
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References_xml | – volume: 59 year: 2011 ident: ref15 article-title: The histopathology of drugs of abuse publication-title: Histopathology doi: 10.1111/j.1365-2559.2010.03728.x – volume: 136 year: 1987 ident: ref3 article-title: Crack lung: pulmonary disease caused by cocaine abuse publication-title: Am Rev Respir Dis doi: 10.1164/ajrccm/136.5.1250 – volume: 17 year: 2019 ident: ref10 article-title: Cocaine-induced bronchospasm mimicking acute asthma exacerbation publication-title: Clin Med Res doi: 10.3121/cmr.2019.1447 – volume: 4 year: 1997 ident: ref11 article-title: New-onset bronchospasm or recrudescence of asthma associated with cocaine abuse publication-title: Acad Emerg Med doi: 10.1111/j.1553-2712.1997.tb03761.x – volume: 192 year: 2014 ident: ref5 article-title: High-resolution computed tomographic findings of cocaine-induced pulmonary disease: a state of the art review publication-title: Lung doi: 10.1007/s00408-013-9553-6 – volume: 28 year: 2012 ident: ref2 article-title: Cocaine intoxication publication-title: Crit Care Clin doi: 10.1016/j.ccc.2012.07.003 – volume: 120 year: 2021 ident: ref1 article-title: Trends and correlates of cocaine use among adults in the United States, 2006-2019 publication-title: Addict Behav doi: 10.1016/j.addbeh.2021.106950 – volume: 19 year: 2012 ident: ref6 article-title: Interstitial lung damage due to cocaine abuse: pathogenesis, pharmacogenomics and therapy publication-title: Curr Med Chem doi: 10.2174/092986712803988901 – volume: 2 year: 2015 ident: ref9 article-title: Severe obstructive pattern mimicking an asthma exacerbation as first presentation of crack smoking: a case report publication-title: Case Rep Intern Med doi: 10.5430/crim.v2n2p60 – volume: 54 year: 2017 ident: ref14 article-title: Asthma associated with the use of cocaine, heroin, and marijuana: a review of the evidence publication-title: J Asthma doi: 10.1080/02770903.2016.1259420 – volume: 99 year: 2007 ident: ref7 article-title: Depression symptoms and substance abuse in adolescents with asthma publication-title: Ann Allergy Asthma Immunol doi: 10.1016/S1081-1206(10)60547-9 – volume: 128 year: 2005 ident: ref12 article-title: The effects of cocaine and heroin use on intubation rates and hospital utilization in patients with acute asthma exacerbations publication-title: Chest doi: 10.1016/S0012-3692(15)52588-9 – volume: 88 year: 1990 ident: ref13 article-title: Cocaine-associated asthma publication-title: Am J Med doi: 10.1016/0002-9343(90)90506-9 – volume: 142 year: 1990 ident: ref4 article-title: Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings publication-title: Am Rev Respir Dis doi: 10.1164/ajrccm/142.2.462 – volume: 110 year: 1996 ident: ref8 article-title: Acute effects of inhaled and i.v. cocaine on airway dynamics publication-title: Chest doi: 10.1378/chest.110.4.904 |
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SubjectTerms | Airway management Allergy/Immunology Asthma Bronchodilators Case reports Cellular biology Cocaine Drug use Dyspnea Edema Emergency medical care Hemorrhage Influenza Internal Medicine Medical imaging Neutrophils Patients Pulmonary arteries Pulmonology Tomography X-rays |
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Title | Cocaine-Induced Asthma and the "Crack Lung": A Case Report |
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