Bilateral thumb burns leading to the diagnosis of crack lung.

Bilateral thumb burns on a young woman admitted to the hospital with the diagnosis of community-acquired pneumonia led us to consider the diagnosis of crack lung despite the fact that the woman denied cocaine use. Cocaine was found on a urine toxicology study, and its use was subsequently confirmed by history. The patient was treated for crack lung with complete resolution of her symptoms and radiographic findings. Inspection of the hands for burns consistent with handling cocaine pipes should prompt a consideration of crack lung in patients with pulmonary infiltrates.