Fatal pulmonary edema following intravenous "freebase" cocaine use.

A 36-year-old man developed extreme shortness of breath after injecting "freebase" cocaine intravenously. Clinical and radiographic evaluation confirmed acute pulmonary edema, and blood gas studies substantiated acute respiratory failure. Despite vigorous therapy, the patient died three hours after admission. When cocaine use causes death, generally it is by respiratory collapse. Although the post-mortem finding of pulmonary edema after cocaine use has been reported, to our knowledge, this is the first reported death due to clinical pulmonary edema after the intravenous use of freebase cocaine.