Eosinophilic "empyema" associated with crack cocaine use. Thorax 2003 Sep;58(9):823-4
Date
08/30/2003Pubmed ID
12947150Pubmed Central ID
PMC1746813DOI
10.1136/thorax.58.9.823Scopus ID
2-s2.0-0042831240 (requires institutional sign-in at Scopus site) 26 CitationsAbstract
Smoking of crystalline cocaine, known as "crack" cocaine, has been associated with eosinophilic pneumonitis, but not with pleural effusions. We describe a patient with eosinophilic pneumonitis with an eosinophilic "empyema" after using "crack" cocaine. The illness resolved with corticosteroids. We hypothesised that his effusion would have increased levels of eosinophil cytokines that promote oedema, and found a marked increase in pleural vascular endothelial growth factor (VEGF) and smaller increases in interleukins IL-5, IL-6, and IL-8. In the setting of "crack" use, we suggest that a pleural effusion that appears grossly to be pus should be evaluated for eosinophilic inflammation. Such eosinophilic effusions may respond to corticosteroids alone, consistent with a non-infectious process driven by proinflammatory cytokines.
Author List
Strong DH, Westcott JY, Biller JA, Morrison JL, Effros RM, Maloney JPAuthor
Julie A. Biller MD Chief, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Administration, OralAdult
Bronchoalveolar Lavage Fluid
Cocaine-Related Disorders
Crack Cocaine
Empyema, Pleural
Glucocorticoids
Humans
Male
Prednisone
Pulmonary Eosinophilia
