Differential Diagnosis of Sympathetic Toxidromes

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Poisoning Pulmonary Edema

Figure 9.4 Noncardiogenic Pulmonary Edema: Crack Cocaine Injection. Frontal chest radiograph that demonstrates normal size and configuration of the cardio-mediastinal silhouette and bilateral diffuse pulmonary edema following the intravenous injection of crack cocaine. Noncardiogenic pulmonary edema may also follow opioid overdoses with the same radiographic patterns. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.4 Noncardiogenic Pulmonary Edema: Crack Cocaine Injection. Frontal chest radiograph that demonstrates normal size and configuration of the cardio-mediastinal silhouette and bilateral diffuse pulmonary edema following the intravenous injection of crack cocaine. Noncardiogenic pulmonary edema may also follow opioid overdoses with the same radiographic patterns. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Toxins: Cocaine, phenycyclidine (PCP), amphetamines, caffeine, hallucinogens, phenyl-propanolamine (PPA), theophylline, ephedrine, pseudoephedrine, tyramine, monoamine oxidase inhibitors (MAOIs).

Metabolic: Thyrotoxicosis, pheochromocy-toma, hypoglycemia, serotonin syndrome, neu-roleptic malignant syndrome. Withdrawal: Ethanol, sedative-hypnotics. Neuropsychiatric: Status epilepticus, mania, psychosis, schizophrenia.

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