Chest
Selected ReportsInhaled Heroin-Induced Status Asthmaticus: Five Cases and a Review of the Literature
Section snippets
Case 1
A 30-year-old, nonsmoking, African-American woman with a history of asthma and heroin abuse was well until “a few hours” prior to admission when she became acutely breathless after snorting heroin. Despite the use of an inhaled β-agonist, she was intubated in the field for respiratory arrest and brought to hospital. She was agitated in the emergency department with the following vital signs: temperature, 36.5°C; pulse, 130 beats/min; BP, 124/80 mm Hg; and respiratory rate, 29 breaths/min by
Discussion
The five cases reported above are examples of status asthmaticus triggered by inhalation of heroin. Common features of these cases include a history of asthma, the sudden and severe nature of the exacerbations, the general lack of responsiveness β-agonists, and peripheral blood eosinophilia (range, 6 to 11% of the total WBC count). Four of five patients were intubated (and the fifth nearly was intubated) for an average of 5 days (range, 2 to 8 days). This protracted course distinguishes these
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