Vape-associated lung injury in an adolescent

Hannah Wilkerson BS, Ganesh Maniam BA, MBA, Ryan E. Dean BS, MBA, Matthew Goldfinger DO, Preetha Kandaswamy MD, Todd Bell, MD


The rise in incidence of e-cigarette or vaping product use associated lung injury (EVALI) and associated deaths has become a growing concern among public health officials. In most cases, the presenting and predominant complaints were respiratory in nature. However, in this case, the chief complaint was gastrointestinal symptoms. A 17-year-old male presented with a two-day history of sore throat, headache, and malaise followed by a one-day history of fever, vomiting, and diarrhea. Additional history revealed that patient was a regular user of THC vape cartridges. Computed tomography (CT) scan of the thorax showed a large right lower lobe consolidation with patchy infiltrates consistent with airspace pneumonia. He was later found to have C. difficile infection on day 3 and was started on metronidazole. After four days of ceftriaxone and supportive treatment, he showed significant improvement and was discharged on hospital day 5 with metronidazole and amoxicillin-clavulanate. In this case, the clinical picture of respiratory or gastrointestinal symptoms in the context of the patient’s using e-cigarettes or vaping products should bring EVALI into the differential diagnosis. Furthermore, this case highlights the need for increased public education regarding the dangers of e-cigarettes and vaping, especially with regard to increasing awareness among adolescent populations.

Keywords: vaping; EVALI; lung injury; public health; electronic THC delivery systems

Article citation: Wilkerson H, Maniam G, Dean RE, Goldfinger M, Kandaswamy P, Bell T. Vape-associated lung injury in an adolescent. The Southwest Respiratory and Critical Care Chronicles 2020;8(35):51–54
From: Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, Texas
Submitted: 4/26/2020
Accepted: 7/7/2020
Reviewer: Kenneth Nugent MD
Conflicts of interest: none
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