Status Asthmaticus Triggered By Heroin Inhalation

 

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