Abstract

A twentysix-year-old male patient was admitted to the emergency service for three days with complaints of increasing dyspnea, fever, cough and sputum. The patient also has 8 pocket / year cigarette smoking, intermittent alcohol and heroin use. In vital symptoms; heart rate was 92, blood pressure was 110/70 mmHg, respiration rate was 35, and fever was 38.2 'C. On physical examination, the general condition was moderate, dyspneic, conscious and cooperative. Bilateral common expiratory rhoncus were present, heart sounds were rhythmic and tachycardic. Other system examination findings were ordinary. SpO2 was 74% in the room air. In arterial blood gas pH was 7.45, pCO2 was 35, mmHg pO2 was 41.2, and mmHg sO2 was 74.3%. The routine biochemical examination were 16.200 mm3 leucocytes, 20.5% eosinophil (3.32), 9.61 mg / dL CRP, and total IGE> 1210. Chest x-ray showed bilateral, diffuse and heterogeneous density and the thorax computed tomography showed bilateral, diffuse, patchy ground-glass opacities. Restrictive pattern was observed in respiratory function test. Flexible fiberoptic bronchoscopic(FOB) examination was performed, transbronchial biopsy was reported as atelectatic lung tissue and bronchoalveolar lavage was not diagnostic. No parasites, fungal or bacterial factors were detected that could explain eosinophilia in the blood, sputum, FOB and stool microbiological examination of the patient. in the presence of these findings the patient was diagnosed with AEP due to heroin inhalation. Radiological and clinical regression was observed after methylprednisolone was started and he quit using heroin.

Illegal drug and any substance use should be carefully examined in cases of interstitial lung disease in young ages.