CTICasesMacklin Phenomenon and Acute Lung Injury from Cocaine and Methamphetamine Abuse
Imaging findings
Chest radiograph and chest CT demonstrate pneumomediastinum and subcutaneous emphysema, with linear air tracking along the bronchovascular bundles. Also present are patchy ground-glass opacities in the anterior lungs and a fractured calcaneus. The patient's toxicology screen was positive for both cocaine and methamphetamine.
Key takeaways
Pneumomediastinum associated with illicit drug inhalation is frequently caused by the Macklin phenomenon, which results from alveolar rupture due to transient, severe increases in intra-alveolar pressure. Coexisting anterior ground-glass opacities may represent acute drug-induced lung injury or alveolar hemorrhage.
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