["Usual" XXXX producing an unusual incident].

@entity825 @entity1 @entity9285 @entity146 @entity1353 @entity2415 @entity835 @entity14303 @entity716 @entity1767 @entity7129 @entity1621 @entity734
CASE HISTORY: A 17-year-old male presented in an agitated, deranged state with rapidly increasing swelling of the neck. Except for regular abuse of @entity835 there was no medical history of note. He had a @entity7129 (130 bpm), a slow pupillary reflex, @entity1621 and @entity9285 around the neck and shoulders. INVESTIGATIONS AND DIAGNOSIS: Laboratory tests showed elevated inflammatory markers. The chest X-ray demonstrated a bilateral pneumothorax and large @entity9285 . Subsequent computed tomography of neck and thorax showed an extensive @entity14303 and the described @entity9285 . There was no evidence of a ruptured @entity825 or esophageal perforation. The underlying cause was presumed to have been a Valsalva maneuver during marijuana smoking. TREATMENT AND COURSE: As the pneumothorax was completely reabsorbed, no chest drains were inserted and the @entity1 was transferred to our toxicological intensive care unit. Recurring drug-induced @entity716 had to be treated with repeated doses of @entity1767 . The @entity2415 was slowly reabsorbed without any further complication. The @entity1 was transferred back to a @entity146 ward after five days. CONCLUSION: Although @entity835 is thought to be one of the "safe" drugs, its abuse can have life-threatening effects. One complication is the occurrence of a pneumothorax after a Valsalva maneuver. As the rate of @entity835 has been increasing during the last few years, the risk of life-threatening complications should be mentioned in relevant publications and as part of drug education. @entity1 presenting with @entity1353 should always be carefully questioned about possible @entity734 .
