Chen Guo-An, Yang Chen-Chang
Cheng Hsin General Hospital Department of Emergency Medicine Taipei Taiwan.
National Yang-Ming University Institute of Environmental and Occupational Health Sciences, School of Medicine Taipei Taiwan.
J Acute Med. 2018 Mar 1;8(1):30-33. doi: 10.6705/j.jacme.201803_8(1).0005.
Pneumothorax, pneumomediastinum and/or subcutaneous emphysema are important differential diagnosis for patients manifesting dyspnea or chest pain in the emergency department (ED). Inhalation of methamphetamine as well as other abuse substances could rarely induce above-noted complications. However, most ED patients are reluctant to reveal the use of illicit substances. Therefore, prompt toxicologic screening is warranted in confirming the diagnosis of substance abuse in the ED. We herein report a 22-year-old male patient who presented to the ED with diffuse subcutaneous emphysema, pneumomediastinum and pneumothorax after methamphetamine inhalation. The diagnosis of methamphetamine abuse was delayed because the patient did not provide the accurate drug exposure history at the outset. With the help of appropriate toxicologic screening, the diagnosis was finally made and early counseling was provided to prevent further drug abuse and the recurrence of pneumothorax/ pneumomediastinum.
气胸、纵隔气肿和/或皮下气肿是急诊科（ED）出现呼吸困难或胸痛患者的重要鉴别诊断。吸入甲基苯丙胺以及其他滥用物质很少会引发上述并发症。然而，大多数急诊科患者不愿透露使用非法物质的情况。因此，在急诊科确诊药物滥用时，及时进行毒理学筛查是必要的。我们在此报告一名22岁男性患者，其在吸入甲基苯丙胺后出现弥漫性皮下气肿、纵隔气肿和气胸并前往急诊科就诊。由于患者一开始未提供准确的药物接触史，甲基苯丙胺滥用的诊断被延迟。在适当的毒理学筛查帮助下，最终做出诊断并提供了早期咨询，以防止进一步的药物滥用和气胸/纵隔气肿复发。
