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Exogenous Lipoid Pneumonia: An Unexpected Complication of Substance Abuse
- Michael N. Gurell, MD;
- R. Matthew Kottmann, MD;
- Haodong Xu, MD; and
- Patricia J. Sime, MD
- From the University of Rochester, Rochester, NY 14642.
Background: Exogenous lipoid pneumonia is an uncommon cause of pulmonary infiltrates resulting from aspiration or inhalation of fat-like material. It is often unrecognized because its symptoms and radiographic appearances are nonspecific and mimic many pulmonary diseases. Generally, affected patients use oil-based laxatives and have risk factors for aspiration. It is not classically considered a consequence of substance abuse.
Objective: To describe a patient with exogenous lipoid pneumonia caused by inhalation of crack cocaine mixed with petroleum jelly.
Case Report: A 42-year-old black man was evaluated for a 6-month history of progressively worsening dyspnea on exertion. He denied associated symptoms, including cough, wheezing, or fever. His medical history included paranoid schizophrenia, and he smoked crack cocaine and tobacco. He lived in a boarding house, had previous exposure to asbestos, and had a remote history of incarceration. His medications included fluticasone, ipratropium, and albuterol inhalers; haloperidol; quetiapine; trihexyphenidyl; and occasional celecoxib. On examination, his …
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