title: Thoracic complications of illicit drug use: an organ system approach.
abstract: Illicit drug use constitutes a major health problem and may be associated with various thoracic complications. These complications vary depending on the specific drug used and the route of administration. Commonly abused drugs that may play a role in causing thoracic disease include cocaine, opiates, and methamphetamine derivatives. Intravenously abused oral medications may contain filler agents that may be responsible for disease. Thoracic complications may be categorized as pulmonary, pleural, mediastinal, cardiovascular, and chest wall complications. Pulmonary complications of drug abuse include pneumonia, cardiogenic edema, acute lung injury, pulmonary hemorrhage, and aspiration pneumonia. Filler agents such as talc may result in panacinar emphysema or high-attenuation upper-lobe conglomerate masses. The primary pleural complication of illicit drug use is pneumothorax. Mediastinal and cardiovascular complications of illicit drug use include pneumomediastinum, cardiomyopathy, myocardial infarction, aortic dissection, and injection-related pseudoaneurysms. Chest wall complications include diskitis and vertebral osteomyelitis, epidural abscess, necrotizing fasciitis, costochondritis, and septic arthritis. Categorization of thoracic complications of illicit drug use may facilitate understanding of these disorders and allow accurate diagnosis.
authors.affiliation: Department of Radiology, San Francisco General Hospital, 1001 Potrero Ave, Rm 1X 55A, Box 1325, San Francisco, CA 94110, USA. michael.gotway@radiology.ucsf.edu
authors.forename: Michael B
authors.initials: MB
authors.lastname: Gotway
authors.forename: Shelley R
authors.initials: SR
authors.lastname: Marder
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Hanks
authors.forename: Jessica W T
authors.initials: JW
authors.lastname: Leung
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Dawn
authors.forename: Alisa D
authors.initials: AD
authors.lastname: Gean
authors.forename: Gautham P
authors.initials: GP
authors.lastname: Reddy
authors.forename: Philip A
authors.initials: PA
authors.lastname: Araoz
authors.forename: W Richard
authors.initials: WR
authors.lastname: Webb
mesh_terms: D000784:Aortic Dissection / Q000139:chemically induced / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000139:chemically induced / Q000000981:diagnostic imaging; D001168:Arthritis / Q000139:chemically induced / Q000000981:diagnostic imaging; D004333:Drug Administration Routes; D019115:Fasciitis, Necrotizing / Q000139:chemically induced / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008171:Lung Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging; D008297:Male; D008478:Mediastinal Emphysema / Q000139:chemically induced / Q000000981:diagnostic imaging; D009203:Myocardial Infarction / Q000139:chemically induced / Q000000981:diagnostic imaging; D010007:Osteochondritis / Q000139:chemically induced / Q000000981:diagnostic imaging; D010019:Osteomyelitis / Q000139:chemically induced / Q000000981:diagnostic imaging; D011026:Pneumopericardium / Q000139:chemically induced / Q000000981:diagnostic imaging; D011030:Pneumothorax / Q000139:chemically induced / Q000000981:diagnostic imaging; D019966:Substance-Related Disorders / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D013896:Thoracic Diseases / Q000000981:diagnostic imaging*; D013909:Thorax / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D013287:Illicit Drugs