Keerthi Yarlagadda1, Pratiksha Singh1, Isha Shrimanker2, Joshua C Hoffman3, Vinod K Nookala1. 1. Department of Internal Medicine, UPMC Pinnacle, 205 S Front St, Suite 3C, Harrisburg, PA 17104, USA. 2. Department of Internal Medicine, UPMC Pinnacle, 205 S Front St, Suite 3C, Harrisburg, PA 17104, USA. Electronic address: ims18919@gmail.com. 3. Pulmonary & Critical Care Medicine Associates, Harrisburg, PA, USA.
Abstract
BACKGROUND: Marijuana is the second most commonly used inhalational agent after tobacco. It has been used for therapeutic benefits in cancer, epilepsy, inflammation and pain. Inhalation of marijuana causes reversible and irreversible lung injury. CASE: We present a 26-year-old female with cough, chest pain, epistaxis, hemoptysis, night sweats and breathlessness few hours after smoking marijuana. Physical exam was positive for tachycardia, tachypnea, and diminished coarse breath sounds. Further investigation revealed elevated white blood cell count, chest X-ray, computed tomography of the chest showed bilateral patchy infiltrates. The patient was managed with short term steroid, as antibiotics alone did not work. Radiological improvement of lung injury was noted within 36-48 h. CONCLUSION: There is a paucity of treatment guidelines for acute lung injury secondary to marijuana inhalation. We advocate early use of short-term steroids and also more awareness on quitting marijuana smoking to prevent life-threatening complications like myocardial infarction, diffuse alveolar hemorrhage and acute respiratory distress syndrome.
BACKGROUND:Marijuana is the second most commonly used inhalational agent after tobacco. It has been used for therapeutic benefits in cancer, epilepsy, inflammation and pain. Inhalation of marijuana causes reversible and irreversible lung injury. CASE: We present a 26-year-old female with cough, chest pain, epistaxis, hemoptysis, night sweats and breathlessness few hours after smoking marijuana. Physical exam was positive for tachycardia, tachypnea, and diminished coarse breath sounds. Further investigation revealed elevated white blood cell count, chest X-ray, computed tomography of the chest showed bilateral patchy infiltrates. The patient was managed with short term steroid, as antibiotics alone did not work. Radiological improvement of lung injury was noted within 36-48 h. CONCLUSION: There is a paucity of treatment guidelines for acute lung injury secondary to marijuana inhalation. We advocate early use of short-term steroids and also more awareness on quitting marijuana smoking to prevent life-threatening complications like myocardial infarction, diffuse alveolar hemorrhage and acute respiratory distress syndrome.