[Alveolar hemorrhage after cocaine inhalation]

Following inhalation of cocaine two young men developed haemoptysis associated with dyspnoea. One of these patients had severe clinical symptoms. There was blood eosinophilia, and haemosiderin was found in the macrophages that were present in the fibroscopic alveolar lavage fluid. X-ray films of the chest showed bilateral micronodular opacities. The outcome was favourable after treatment with parenteral dexamethasone, oxygen therapy and mask-administered continuous positive pressure ventilation. The frequency of cocaine-induced alveolar haemorrhage is probably underestimated; the condition must be suspected in subjects who inhale cocaine and have haemoptysis, no matter how small.