@article{ref1,
title="Haemoptysis following shallow breath-hold diving in a cannabis user",
journal="BMJ case reports",
year="2020",
author="Borg, Janice and Cassar, Julian and Bonello, Sarah and Fsadni, Peter",
volume="13",
number="6",
pages="e4921-e4921",
abstract="We report the first case of a healthy 24-year-old male with a 6-year history of regular cannabis use, who presented with haemoptysis after a shallow 3 m breath-hold dive. Blood investigations showed mild neutrophilia. CT thorax revealed focal ground-glass changes in the superior segment of the lower lobe. With a suspicion of pneumonia, oral antibiotics were initiated to poor effect. Through bronchoscopic visualisation and lavage, a diagnosis of diffuse alveolar haemorrhage was established. The clinical course was benign with resolution of symptoms and changes on CT thorax within 6 weeks of stopping marijuana use. Since all other causes of haemoptysis were excluded, pathophysiology was attributed to cannabis-induced lung parenchymal damage, exacerbated by a shallow breath-hold dive. To ensure appropriate management, a clinician should therefore have a high index of suspicion for drug use and other factors known to cause chronic lung damage in whom other causes of diffuse alveolar haemorrhage are excluded.<p /> <p>Language: en</p>",
language="en",
issn="1757-790X",
doi="10.1136/bcr-2020-234921",
url="http://dx.doi.org/10.1136/bcr-2020-234921"
}