Pulmonary microcrystalline cellulose deposition from intravenous injection of oral medication in a patient receiving parenteral nutrition

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 27; no. 1; pp. 91 - 92
• Main Authors: Ott, MC, Khoor, A, Scolapio, JS, Leventhal, JP
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2003; ASPEN
• Subjects: Analgesics, Opioid - administration & dosage; Biological and medical sciences; Cellulose - adverse effects; Codeine - administration & dosage; Drug toxicity and drugs side effects treatment; Excipients - adverse effects; Humans; Injections, Intravenous - adverse effects; Lung - diagnostic imaging; Male; Medical sciences; Middle Aged; Parenteral Nutrition; Pharmacology. Drug treatments; Tomography, X-Ray Computed; Toxicity: respiratory system, ent, stomatology; Human; Lung disease; Intravenous administration; Catheterization; Respiratory disease; Toxicity; Lung; Oral administration; Male; Opiates; Route of administration; Parenteral administration; Feeding; Case study; Infiltrate; At home; Adult; Complication; Foreign body
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1177/014860710302700191

A 50-year-old man who had been dependent on home parenteral nutrition (HPN) for 24 years presented with shortness of breath. A computed tomography scan of the lungs revealed a diffuse micronodular parenchymal infiltrate. On bronchoscopy, a crystalloid material was identified. This organic material was determined to be consistent with codeine. The patient had been injecting codeine into his intravenous catheter. This is a case report of a long-term HPN patient presenting with pulmonary embolisms secondary to infusion of codeine tablets through his central catheter.