heroin and Pulmonary-Eosinophilia

Smoking heroin (chasing the dragon), is a method of inhaling heroin via heating the drug on a tin-foil above a flame. It also has been associated both with the indirect effects of heroin overdose and with direct pulmonary toxicity. We describe a case of acute eosinophilic pneumonia secondary to heroin inhalation in our medical intensive care unit. She presented with fever, cough, dyspnea and pleuritic chest pain. Chest radiograph showed bilateral infiltrations. Examination of bronchoalveolar lavage fluid revealed significant eosinophilia. She was diagnosed with acute eosinophilic pneumonia. After heroin abstinence and corticosteroid therapy, remission was achieved rapidly and the patient was discharge on the fourth day of her hospital stay.

Topics: Acute Disease; Bronchoalveolar Lavage Fluid; Female; Heroin; Humans; Prednisolone; Pulmonary Eosinophilia; Tomography, X-Ray Computed; Young Adult

Drugs are known to be a cause of pulmonary eosinophilia and several case reports of acute eosinophilic pneumonia associated with the use of cocaine have been reported. The changing pattern of heroin use, with a shift from intravenous use to smoking/inhalation of the substance, may lead to increased prevalence of heroin-induced pulmonary eosinophilia. We report on a case of a patient who had been inhaling heroin for about ten years. He presented with fever, cough, dyspnea and pleuritic chest pain. Chest radiograph showed unilateral pleural effusion with segmental atelectasis. Examination of pleuritic fluid aspirate and bronchoalveolar lavage fluid revealed significant eosinophilia. He was diagnosed with acute eosinophilic pneumonia. Rapid remission was achieved after heroin abstinence and initiation of corticosteroid treatment.

Topics: Administration, Inhalation; Adult; Bronchoalveolar Lavage Fluid; Eosinophils; Heroin; Heroin Dependence; Humans; Leukocyte Count; Male; Narcotics; Pulmonary Eosinophilia; Tomography, X-Ray Computed

Topics: Administration, Inhalation; Adrenal Cortex Hormones; Adult; Asthma; Female; Heroin; Humans; Pulmonary Eosinophilia; Substance-Related Disorders

Inhalation of heroin is known to provoke asthma. We report on the case of a patient who, after repeated inhalation of heroin, presented with decreased lung volume associated with bronchial hyperresponsiveness, diffuse pulmonary infiltrates, and bronchoalveolar lavage fluid eosinophilia. Rapid remission was obtained after heroin abstinence and initiation of corticosteroid treatment.

Topics: Acute Disease; Administration, Inhalation; Adult; Female; Heroin; Humans; Pulmonary Eosinophilia; Substance-Related Disorders

Drug-induced lung diseases may present themselves as bronchial reactions (e.g. bronchial asthma), diseases of the parenchyma (e.g. pulmonary infiltrates with eosinophilia, diffuse fibrosing alveolitis), of the pulmonary vasculature (vasculitis) and of the pleura (e.g. pleurisy or pleural fibrosis). Pathogenetically the two most pertinent types of reaction are hypersensitivity or toxic reactions, and less often biologic reactions such as opportunistic infections after cytotoxic and immunosuppressive therapy. Many drug-induced respiratory diseases are reversible upon withdrawal of the offending agent; others may be irreversible or even progress.

Topics: Aspirin; Asthma; Bronchitis; Busulfan; Contraceptives, Oral, Hormonal; Dose-Response Relationship, Drug; Drug Hypersensitivity; Drug Interactions; Drug Tolerance; Heroin; Humans; Iodides; Lung Diseases; Methysergide; Pituitary Hormones, Posterior; Pleural Diseases; Polyarteritis Nodosa; Pulmonary Edema; Pulmonary Embolism; Pulmonary Eosinophilia; Trypsin