A 50 year old man presents with shortness of breath and a cough two days after taking the substance above. He also has melanoptysis (that is, black sputum). He has thermal burns on his thumbs. He is hypoxic and a bronchoscopy is performed. The bronch shows bloody lavage. Cell count shows eosinophilia. The CXR and CT are shown below.
Challenge: What's the diagnosis?
First image is in the public domain, second image is shown under Fair Use.
crack coccaine addict!
ReplyDeletedon't mind the pun in the title - you're right :)
ReplyDelete-
Crackles
This is crack lung, acute pulmonary toxicity manifested by diffuse alveolar damage and hemorrhagic alveolitis. It is due to smoking crack (free-based cocaine). Melanoptysis is probably due to inhalation of carbonaceous residue. The CXR shows basilar opacities. The CT shows bilateral ground glass opacities.
Sources: UpToDate; Wikipedia.
He have some mild scoliosis going on as well?
ReplyDeleteyep - i think that's true - clavicles look pretty symmetric and you can see some scoliotic changes in the spine
ReplyDelete