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Eosinophilic "empyema" associated with crack cocaine use
D H Strong1, J Y Westcott, J A Biller
1Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
Thorax
|August 30, 2003
Summary
Crack cocaine use can cause eosinophilic lung disease and pleural effusions. This case study suggests effusions may be treated with corticosteroids alone, indicating a non-infectious inflammatory process.
Area of Science:
- Pulmonology
- Toxicology
- Cytokine Research
Background:
- Crack cocaine smoking is linked to eosinophilic pneumonitis.
- Pleural effusions are not typically associated with crack cocaine use.
Observation:
- A patient presented with eosinophilic pneumonitis and an eosinophilic pleural effusion after smoking crack cocaine.
- The patient's condition improved with corticosteroid treatment.
Findings:
- The pleural effusion showed elevated levels of vascular endothelial growth factor (VEGF) and interleukins (IL-5, IL-6, IL-8).
- These cytokines are associated with edema and inflammation.
Implications:
- Pleural effusions in crack cocaine users, even if appearing purulent, should be investigated for eosinophilic inflammation.
- Corticosteroid therapy may be effective for such non-infectious, cytokine-driven effusions.
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