Wiesel Shimshon, Siddiqui Faraz, Khan Tahir, Hossri Sami, El-Sayegh Dany
Internal Medicine, Staten Island University Hospital, Northwell Health.
Pulmonary and Critical Care Medicine, Staten Island University Hospital, Northwell Health.
Cureus. 2017 Jul 31;9(7):e1530. doi: 10.7759/cureus.1530.
Marijuana use has been increasing across the United States due to its legalization as both a medicinal and recreational product. A small number of case reports have described a pathological entity called vanishing lung syndrome (VLS), which is a rare bullous lung disease usually caused by tobacco smoking. Recent case reports have implicated marijuana in the development of VLS. We present a case of a 47-year-old man, who presented to our hospital with shortness of breath, fevers and a productive cough. On physical exam, he was tachypneic with audible stridor and absent right sided breath sounds. Laryngoscopy showed a retropharyngeal abscess, and chest radiography showed a possible right pneumothorax. Chest computed tomography (CT) showed bilateral bullous emphysematous lung disease with a giant bulla occupying most of his right lung field. He was placed on mechanical ventilation and treated with broad spectrum antibiotics in the intensive care unit, where he developed acute respiratory distress syndrome (ARDS). He continued to decline, and developed disseminated intravascular coagulation, after which he succumbed to his disease.
由于大麻作为药用和娱乐用产品的合法化，美国各地使用大麻的情况一直在增加。少数病例报告描述了一种名为消失肺综合征（VLS）的病理实体，这是一种罕见的大疱性肺病，通常由吸烟引起。最近的病例报告表明大麻与VLS的发生有关。我们报告一例47岁男性病例，该患者因呼吸急促、发热和咳痰前来我院就诊。体格检查时，他呼吸急促，可闻及喘鸣音，右侧呼吸音消失。喉镜检查显示咽后脓肿，胸部X线片显示可能存在右侧气胸。胸部计算机断层扫描（CT）显示双侧大疱性肺气肿性肺病，一个巨大的肺大疱占据了他右侧大部分肺野。他被置于机械通气，并在重症监护病房接受广谱抗生素治疗，在那里他发展为急性呼吸窘迫综合征（ARDS）。他的病情持续恶化，并发弥散性血管内凝血，最终因病死亡。
