Our patient was exposed to burning sumac smoke while clearing out her yard .  Toxicodendron vernix is a woody shrub or tree which can grow to 30 ft. It contains urushiol which is the same resin in poison ivy and poison oak but is more toxic in sumac.  Poison ivy has a C15 side chain, poison oak has a C17 side chain and poison sumac has a C13 side chain.   Whensumac  burned, the smoke can cause breakdown in the lining of the lungs causing ARDS.  #Clinical #EM #Tox #Radiology #CTChest #Sumac #Urushiol #Smoke #Inhalation