title: Pulmonary hemorrhage: a rare complication of opioid overdose.
abstract: Children and adolescents with pulmonary hemorrhage are infrequently encountered in the emergency department (ED). We describe a case of a 16 year-old boy who presented to a pediatric ED with pulmonary hemorrhage and respiratory distress. The patient's unusual initial presentation resulted in the consideration of a broad differential diagnosis for his symptoms, including traumatic, neurological, respiratory, and toxicological causes. After resuscitation in the ED, a prolonged admission, and extensive testing, no cause could be found other than severe opioid toxicity. This case illustrates a rare, life-threatening presentation of opiod toxicity in a healthy adolescent and underlines the potentially serious nature of such exposures.
authors.affiliation: Discipline of Pediatrics, Faculty of Medicine, Memorial University of Newfoundland, Newfoundland and Labrador, Canada. rporter@mun.ca
authors.forename: Robert
authors.initials: R
authors.lastname: Porter
authors.forename: Heather
authors.initials: H
authors.lastname: O'Reilly
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001980:Bronchi / Q000098:blood supply; D001999:Bronchoscopy; D002097:C-Reactive Protein / Q000032:analysis; D018450:Disease Progression; D062787:Drug Overdose; D004636:Emergency Service, Hospital; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced*; D008297:Male; D009020:Morphine / Q000009:adverse effects*; D009270:Naloxone / Q000009:adverse effects / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D012039:Regional Blood Flow; D013224:Status Asthmaticus / Q000175:diagnosis
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone; D009020:Morphine; D002097:C-Reactive Protein