Differential Diagnosis for Condition that Flares Up Upon Cocaine Usage

• Single Most Likely Diagnosis
  • Cocaine-induced vasculitis or vasospasm: This is a common and well-documented condition where cocaine use leads to the constriction or inflammation of blood vessels, which can cause a variety of symptoms depending on the affected area, including skin, brain, or other organs.
• Other Likely Diagnoses
  • Hypertensive crisis: Cocaine is a potent stimulant that can significantly increase blood pressure, leading to a hypertensive crisis, which may manifest with symptoms such as severe headache, chest pain, or shortness of breath.
  • Cardiac conditions (e.g., myocardial infarction, arrhythmias): Cocaine use is associated with increased risk of heart problems due to its effects on the cardiovascular system, including increased heart rate and blood pressure.
  • Seizures or epilepsy: Cocaine can lower the seizure threshold, making it more likely for individuals to experience seizures, especially with heavy or frequent use.
• Do Not Miss Diagnoses
  • Aortic dissection: Although rare, cocaine use can lead to a significant increase in blood pressure, which may cause an aortic dissection, a life-threatening condition where the inner layer of the aorta tears.
  • Stroke (ischemic or hemorrhagic): The vasospastic and hypertensive effects of cocaine can increase the risk of stroke, which is a medical emergency.
  • Pulmonary embolism: Cocaine use can increase the risk of blood clots, potentially leading to a pulmonary embolism, a condition where a blood clot blocks an artery in the lungs.
• Rare Diagnoses
  • Levamisole-induced vasculitis: Levamisole is a contaminant sometimes found in cocaine, which can cause an autoimmune response leading to vasculitis, a condition characterized by inflammation of the blood vessels.
  • Cocaine-induced pneumothorax or pneumomediastinum: These are rare but potentially life-threatening conditions where air leaks into the space between the lungs and chest cavity or into the mediastinum, respectively, which can be associated with cocaine use, possibly due to vigorous inhalation or other mechanisms.