Clinical-radiologic correlation suggest that DAD/pulmonary hemorrhage was the two most likely finding however, infection and aspiration is also a consideration. Please note all of the above can be associated cocaine/illicit drug use. There are no specific imaging features for ilicit drug use, but a strong suspicion is placed when an young adult present with diffuse lung disease without an apparent cause. Subsequent pulmonary wedge biopsy, which showed an eosinophilic infiltrate. consistent with crack cocaine smoking.