and 1 other(s)
We present a case-report of a 15-year-old girl who developed severe respiratory failure following illicit drug use in the context of an unusual social background. The patient presented to hospital with a 2 day history of haemoptysis and fever. She was continued to deteriorate following admission and required mechanical ventilation with a presumed diagnosis of pneumonia. Her ventilated course was unusual and pneumonia could not be confirmed. This initiated re-exploration of her history with the discovery of a significant social background. The child’s parents had befriended a homeless man whom, it was later discovered, used illicit substances, was a sex-offender and had been recently released from prison. As a result the patient became involved with drug misuse. The exact number of substances used was not known but included cannabis, cocaine and heroin. Multiple subsequent investigations were negative but a lung biopsy showed likely pneumonitis, likely secondary to inhalation injury or ‘Crack-Lung’, due to its bronchio-central distribution. Her course was severe and prolonged; she was ventilated for 34 days, failed on ‘High-Frequency Oscillated Ventilation’ and was considered for ‘Extracorporeal-Membrane-Oxygenation’. Social history can be neglected during an acute presentation especially when ‘the story fits’. In this case, the subsequent story did not fit and further exploration was warranted. Fortunately, ‘Crack-Lung’ is not frequently encountered by paediatricians. This case emphasises the importance of a meticulous social history with a degree of suspicion to aid the detection of unexpected diagnoses, usually found in the adult population.
No datasets are available for this submission.
No license information is available for this submission.