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Pleuritic chest pain and fluid levels on imaging in a heavy cannabis smoker

We present the case of a 48-year-old man with an extensive cannabis smoking history who presented with pleuritic chest pain. A chest X-ray revealed multiple large, apical lung bullae with fluid levels, an appearance consistent with infection. Lung function tests showed moderate airflow obstruction and decreased gas transfer. The infection was treated with a prolonged course of antimicrobials, and the patient followed up by respiratory physicians.