Allergic Bronchopulmonary Aspergillosis Associated with Smoking Moldy Marihuana

Llamas, Roberto de la Plaza; Hart, D.; Schneider, Neil

doi:10.1378/chest.73.6.871

Cited by 67 publications

(31 citation statements)

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“…There have been two reported cases of ABPA associated with mouldy marijuana 7,8. Given the frequency of asthma and ABPA, and the high frequency of marijuana usage amongst young people, these cases may represent a tiny proportion of those affected.…”

Section: Discussionmentioning

confidence: 99%

Too Many Mouldy Joints – Marijuana and Chronic Pulmonary Aspergillosis

Gargani¹,

Bishop²,

Denning³

2011

Mediterr J Hematol Infect Dis

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Section: Discussionmentioning

confidence: 99%

Too Many Mouldy Joints – Marijuana and Chronic Pulmonary Aspergillosis

Gargani¹,

Bishop²,

Denning³

2011

Mediterr J Hematol Infect Dis

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“…[37][38][39][40] Marijuana can be a highly contaminated source of Aspergillus. 39,40 This fungus has been cultured from marijuana cigarettes.…”

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confidence: 99%

Sino-orbital Aspergillosis in Acquired Immunodeficiency Syndrome

Johnson¹,

Casiano²,

Kronish

et al. 1999

Arch Ophthalmol

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To describe the clinical features, causes, imaging characteristics, treatment, and outcome of patients with the acquired immunodeficiency syndrome (AIDS) and sino-orbital aspergillosis.Design: Records of 5 patients were reviewed. Results of imaging and histopathologic examinations and clinical courses of the patients were studied.Results: There were 3 women and 2 men (mean age, 34.0 years). All had received a diagnosis of AIDS, and mean CD4 + cell count was 0.014 ϫ 10 9 /L (14 cells/mm 3 ). Computed tomographic scanning exhibited heterogeneous, enhancing sino-orbital soft tissue lesions with bony erosion, and magnetic resonance imaging disclosed soft tissue masses hypointense on T 1 -and T 2 -weighted images. The infection involved 1 or more paranasal sinuses, with extension into the right orbit in 3 patients and into the left orbit in 2. Patients were treated with aggressive surgical debridement and intravenous antifun-gal agents. In addition, local irrigation of amphotericin B was performed in 3 patients. Aspergillus fumigatus was found to be the cause in all 5 patients. Intracranial extension developed in 4 patients, and all subsequently died. The 2 longest surviving patients were the only ones being treated with protease inhibitors. Three patients had a history of frequent marijuana smoking.Conclusions: Sino-orbital aspergillosis is a progressive, relentless, and usually fatal opportunistic infection of advanced AIDS. Patients are first seen with longstanding headache and proptosis with minimal external inflammatory signs. Marijuana smoking may increase the risk for development of sino-orbital aspergillosis in these patients. Aggressive surgical and medical treatment, combined with newer combination therapies using protease inhibitors, may improve the longevity of these patients.

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“…47e49 A case of allergic bronchopulmonary aspergillosis attributed to fungal contamination of the patient's marijuana supply has been described. 50 Anaphylaxis after intravenous use of marijuana has been reported. 51 Although supportive allergy testing was not performed in this case, the patient's history was strongly suggestive with the development of facial edema, truncal urticaria, pruritus, dyspnea, and wheezing within minutes of intravenous exposure.…”

Section: Legal Backgroundmentioning

confidence: 99%