Pulmonary complications associated with illicit drug use. An update.

Abstract

STUDY OBJECTIVE: In earlier years, nonopportunistic infectious pulmonary complications of illicit drug use were most common. We designed this study to update the pulmonary complications associated with illicit drug use in the 1990s. DESIGN: Concurrent and retrospective chart review. SETTING: Inner-city municipal hospital. PATIENTS: All illicit drug users with pulmonary complications seen by the pulmonary consult service were enrolled in the study. There were 105 hospital admissions of 97 patients in a 14-month study period. RESULTS: Sixty percent of the patients had HIV infection. The most common pulmonary complications were Pneumocystis carinii pneumonia (30%) followed by community-acquired pneumonia (12%) and tuberculosis (9%). CONCLUSIONS: The spectrum of pulmonary disease in illicit drug users has changed since 1988. Opportunistic HIV-related disease is much more common. Community-acquired pneumonia and tuberculosis remain relatively frequent complications. Septic pulmonary embolism is now rare.