What are the signs and symptoms of "crack lung" in cocaine toxicity?

Updated: Dec 31, 2020
  • Author: Lynn Barkley Burnett, MD, EdD, JD; Chief Editor: Sage W Wiener, MD  more...
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"Crack lung," a syndrome usually occurring 1-48 hours after cocaine smoking, is a hypersensitivity pneumonitis. It consists of the constellation of the following:

  • Chest pain
  • Cough with hemoptysis
  • Dyspnea
  • Bronchospasm
  • Pruritus
  • Fever
  • Diffuse alveolar infiltrates without effusions
  • Pulmonary and systemic eosinophilia

Barotrauma, such as pneumothorax and pneumomediastinum, may result from smoking or snorting cocaine and then performing a prolonged Valsalva maneuver to increase the effect of the drug, or from coughing against a closed glottis. The increased airway pressure ruptures an alveolar bleb, and free air dissects along peribronchial paths into the mediastinum and pleural cavities.

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