Cutaneous Excoriations and Severe Lung Injury Associated with Chronic Methamphetamine Abuse: A Case Report

Abstract

Background: Methamphetamine (METH) abuse is a growing public health problem with complex, multisystemic complications. While central nervous system and cardiovascular side effects are well known, cutaneous manifestations such as "meth sores" and non-cardiogenic toxic lung injury remain underrecognized, often leading to misdiagnosis or inappropriate microbial therapy. Case Presentation: A case is presented of a 43-year-old male with a history of chronic METH abuse and poorly controlled type 2 diabetes, admitted with progressive dyspnea and severe hypoxemia. Thoracic computed tomography demonstrated extensive alveolar consolidation and bilateral patchy alveolo-interstitial opacities. Concurrently, dermatological consultation and skin biopsy confirmed METH-induced skin excoriations ("meth sores"). Despite broad-spectrum antimicrobial coverage and intensive supportive care, the patient experienced progressive respiratory failure secondary to severe METH-induced toxic pneumonitis and ultimately succumbed to the illness. Conclusions: METH toxicity can present with severe, overlapping dermatological and pulmonary complications. Recognizing "meth sores" provides a crucial clinical key to suspecting substance abuse, avoiding unnecessary diagnostic procedures, and identifying METH-induced toxic pneumonitis in patients with refractory respiratory failure.

Keywords: Methamphetamine, Meth sores, Excoriations, Toxic lung injury, Acute respiratory distress syndrome, Case report.