Emphysema is characterized by permanent

Emphysema is characterized by permanent enlargement of air spaces distal to terminal bronchiole accompanied by destruction

walls of the alveoli. Loss of elastic tissue contained in mezhalveolyarnyh walls due to an imbalance between proteinases and

antiproteinazy activities, often caused by smoking. Congenital deficiency

-antitrypsin, the most famous antiproteinazy is an important risk factor for premature emphysema. In addition, various other causes have been reported including intravenous drugs, including Ritalin

. More recently, Johnson and others

reported four cases bullosa emphysema associated with smoking marijuana. We want to tell more serious event >> << premature bullous emphysema of the lungs in a person with a long history of cocaine smoking. To our knowledge, this ratio >> << only once reported in the Spanish medical literature. 40-year-old man admitted with progressive shortness of breath, cough and high fever. According to relatives, he smoked cocaine (so called free basing) for the past 17 years. Reliable history of cigarette smoking could not be obtained because of his respiratory failure and a low level of consciousness. His medical history includes recurrent respiratory infections. Chest radiographs and CT scans showed striking bilateral bullous emphysema with a large air-fluid accumulation in the right lung, suggesting pulmonary abscess formation (fig,,

). Because of progressive respiratory failure he was intubation and mechanical ventilation. Further treatment lasix drug reactions consisted of intravenous

broad-spectrum antibiotics (clindamycin and ceftazidime-clavulanate then amoxicillin) and chest tube drainage

because the fan associated pneumothorax. The patient eventually died from treatment resistant rejection >> << respiratory pneumonia resulting in reduced residual lung tissue. Sputum gave

Enterobacter cloaca and streptococci. HIV infection was excluded serologically. The final diagnosis of cocaine-induced emphysema has been created >> << after

antitrypsin concentration was within normal limits. -Antitrypsin, cocaine smoking should be considered as a possible cause of severe premature bullous emphysema. Abscess formation and

rapidly progressive respiratory failure may complicate this condition. .