A severe complication of crack cocaine use

Abstract

The present report describes a 48-year-old woman with a history of recurrent 'crack' cocaine use, who developed progressive shortness of breath over a period of years. Serial imaging revealed progressive interstitial fibrosis secondary to recurrent alveolar hemorrhage and inflammation from crack cocaine. The present case serves as a reminder of the numerous sequelae of crack cocaine use, highlighting one particularly severe outcome.

Figure 1)

Chest computed tomography at initial presentation demonstrating bilateral symmetrical airspace disease in a predominant central distribution with multiple acinar opacities and centrilobular nodules in the right lower lobe

Figure 2)

Mild peribronchiolar chronic inflammation and scattered foci of organizing pneumonia (circle) (hematoxylin and eosin stain, original magnification × 40)

Figure 3)

Chest computed tomography three years after initial presentation demonstrating bilateral diffuse ground-glass and peripheral reticular opacities. The presence of reticulation and traction bronchiolectasis (arrows) indicates early interstitial fibrosis

Figure 4)

Chest computed tomography scan 10 years after initial presentation demonstrating diffuse coarse reticular opacities with minimal ground-glass opacities, traction bronchiectasis (arrow) and early honeycombing formation (arrowhead), compatible with severe interstitial fibrosis