title: A Case of Pulmonary Foreign Body Granulomatosis Secondary to Intravenous Injection of Acetaminophen/Oxycodone.
abstract: Foreign body granulomatosis is a rare complication of intravenous injection of pulverized oral prescription tablets. We present the case of an active duty male who was ultimately diagnosed with foreign body granulomatosis caused by the crushing and intravenous injection of acetaminophen with oxycodone (Percocet). The 24-year-old patient initially presented with multiple syncopal episodes, hemoptysis and hypoxia. The patient presentation and imaging findings involved in foreign body granulomatosis can mimic many pulmonary disorders and can be widely variable. Diagnosis is made following lung biopsy. The disease has irreversible effects and patients usually have a progressive decline in pulmonary function. Treatment is supportive although lung transplantation may be beneficial in patients with end-stage lung disease. Pulmonary foreign body granulomatosis should be considered in patients presenting with unexplained hypoxia and imaging consistent with diffuse micronodular disease.
authors.affiliation: Department of Medicine, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920.
authors.forename: Pratik
authors.initials: P
authors.lastname: Naik
authors.affiliation: Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905.
authors.forename: Laura
authors.initials: L
authors.lastname: Cashin
authors.affiliation: Department of Pathology, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920.
authors.forename: Sonny
authors.initials: S
authors.lastname: Huitron
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects* / Q000627:therapeutic use; D061605:Administration, Intravenous / Q000009:adverse effects*; D000328:Adult; D004338:Drug Combinations; D015745:Granuloma, Foreign-Body / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology; D006469:Hemoptysis / Q000150:complications / Q000188:drug therapy; D006801:Humans; D000860:Hypoxia / Q000150:complications / Q000188:drug therapy; D008168:Lung / Q000002:abnormalities / Q000503:physiopathology; D008297:Male; D008889:Military Personnel; D010098:Oxycodone / Q000009:adverse effects* / Q000627:therapeutic use; D013575:Syncope / Q000150:complications / Q000188:drug therapy
chemical_list: D004338:Drug Combinations; C514822:oxycodone-acetaminophen; D000082:Acetaminophen; D010098:Oxycodone