A patient who abuses heroin by inhalation may develop bronchospasm that can result in status asthmaticus.
Clinical features:
(1) history of heroin snorting and/or smoking
(2) onset of status asthmaticus triggered by the heroin inhalation
(3) exclusion of other conditions that can explain the bronchospasm
(4) poor response to beta-agonist therapy
Risk factors:
(1) history of poorly controlled asthma
(2) allergenic agent(s) used to cut the heroin
Laboratory findings:
(1) peripheral blood eosinophilia
(2) positive screening tests for heroin and its metabolites
Differential diagnosis:
(1) asthma exacerbation triggered by another stimulus
(2) heroin-associated noncardiogenic pulmonary edema
(3) bronchiolitis or other pulmonary infection
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Specialty: Toxicology, Emergency Medicine, Critical Care
ICD-10: ,