• Rashmi Mishra, Ravi Patel, and Misbahuddin Khaja.
• Division of Pulmonary and Critical Care Medicine Department of Medicine, Bronx Lebanon Hospital Center, Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY.
• Medicine (Baltimore). 2017 May 1; 96 (19): e6917.

RationaleMarijuana use has been increasing in the United States among college students and young adults. Marijuana use has been associated with bullous lung disease which can lead to pneumothorax. There are other recreational drugs like methylphenidate, cocaine and heroin which have been associated with pneumothorax.Patient ConcernsWe present a case of a 30-year-old man with spontaneous pneumothorax associated with marijuana use. The patient had no medical conditions and presented to the emergency room with chest pain. The physical examination revealed decreased breath sound on the right side of the chest.DiagnosesBed side ultrasound of chest showed stratosphere sign, absent lung sliding; consistent with right-sided pneumothorax.Interventions And OutcomesThe patient underwent placement of a chest tube. Computed tomography chest scans performed on day two also showed bullous lung disease in the right lung. Serial x-rays of the chest showed re-expansion of the lung.LessonsDespite the beneficial effects of Marijuana there are deleterious effects which are emphasized here. This case highlights the need for further studies to establish the relationship between marijuana use and lung diseases in the absence of nicotine use.

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