Pulmonary Effects of Marijuana Inhalation

Megan L Howden; Matthew T Naughton

Disclosures

Expert Rev Resp Med. 2011;5(1):87-92. 

In This Article

Case Report

A 48-year-old woman without prior medical diagnoses was admitted to the respiratory unit with an infected right apical bulla. The patient had a background of both tobacco cigarette (30 pack-years) and marijuana smoking (20 joint-years). On admission she was febrile, with raised inflammatory markers (white cell count and C-reactive protein). She was treated with intravenous antibiotics followed by a protracted course of oral antibiotics after discharge. High-resolution computed tomography (CT) images and lung function are shown in Figures 1A & B and Table 1.

Figure 1.

Two representative slices of a high-resolution CT scan of lung apices of a 48-year-old woman with a history of heavy marijuana and tobacco smoking. The scans shows multiple large bullae in the lung apices.

The CT scan (Figures 1A & B) revealed bilateral apical bullae. Figure 1A shows the infected bulla with fluid filling the cavity. Lung function, however, showed a preserved forced expiratory volume in 1 s (FEV1) with a raised forced vital capacity (FVC) (Table 1). The carbon monoxide diffusion capacity is minimally reduced. Other lung volumes are within normal limits. This is incompatible with a diagnosis of chronic obstructive pulmonary disease. The α-1-antitrypsin level was normal. This patient was felt to have bullous disease in part due to the history of heavy marijuana use, although tobacco smoking is likely to have also contributed. She failed to attend the clinic after discharge. This patient is an example of those with significant marijuana smoking history and bullous lung disease, although a causal link cannot be proven.[1]

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