Pleurisy secondary to nonthrombotic pulmonary emboli in a patient with intravenous drug use.

Autor:	Saeed H; RWJBarnabas Health, Trinitas Regional Medical Center, 225 Williamson St., Elizabeth, NJ, 07202, USA., Marmolejos L; RWJBarnabas Health, Trinitas Regional Medical Center, 225 Williamson St., Elizabeth, NJ, 07202, USA., Patel R; RWJBarnabas Health, Trinitas Regional Medical Center, 225 Williamson St., Elizabeth, NJ, 07202, USA., Shankar T; RWJBarnabas Health, Trinitas Regional Medical Center, 225 Williamson St., Elizabeth, NJ, 07202, USA., Latif A; RWJBarnabas Health, Trinitas Regional Medical Center, 225 Williamson St., Elizabeth, NJ, 07202, USA., Naqi M; RWJBarnabas Health, Trinitas Regional Medical Center, 225 Williamson St., Elizabeth, NJ, 07202, USA., Farrer W; RWJBarnabas Health, Trinitas Regional Medical Center, 225 Williamson St., Elizabeth, NJ, 07202, USA., Remolina C; RWJBarnabas Health, Trinitas Regional Medical Center, 225 Williamson St., Elizabeth, NJ, 07202, USA.
Jazyk:	angličtina
Zdroj:	Respiratory medicine case reports [Respir Med Case Rep] 2023 Jun 04; Vol. 45, pp. 101884. Date of Electronic Publication: 2023 Jun 04 (Print Publication: 2023).
DOI:	10.1016/j.rmcr.2023.101884
Abstrakt:	Patients with injection drug use can have nonthrombotic pulmonary emboli (NTPE) of foreign insoluble particles that are either parts of the equipment used or mixed with the drug as an additive. These foreign particles can become a nidus for infection and inflammation. We present a case of a 31-year-old man with active intravenous drug use who initially presented with signs and symptoms of pleurisy and was found to have NTPE of septic refractile crystalline material as seen on bronchial wash and brush biopsy. We believe our patient likely had embolism of either crack particles, needle fragments or cotton-wool fragments that led to a localized inflammatory reaction and infection. This highlights the importance of obtaining detailed history and diagnostic workup. Once the diagnoses of bacterial endocarditis and thrombophlebitis are ruled out with blood cultures, transthoracic echocardiogram, trans -esophageal echocardiogram and/or CT scan (depending on the suspicion), NTPE should be considered and bronchoscopy with bronchoalveolar lavage with biopsy should be performed. Competing Interests: There are no conflicts of interest to disclose. (© 2023 Published by Elsevier Ltd.)
Databáze:	MEDLINE
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