A teenage vaper on the brink of death had to be put on a ventilator after e-cigarettes caused her lungs to become inflamed and covered in spots, indicating damage.
The 19-year-old presented to the emergency room with abnormally high glucose levels, difficulty breathing, fever and an insufficient amount of oxygen in her blood.
He was initially diagnosed with severe bacterial pneumonia, which was treated with antibiotics.
But when antibiotics did nothing to improve his condition, doctors were stumped.
Scans showed translucent spots throughout his lungs, suggesting they were filled with fluid and signs of tissue damage.
A scan of the patient’s lungs on the left reveals fuzzy spots called glass opacities that doctors initially mistook for signs of bacterial pneumonia.
Finally they asked her if she was an e-cigarette user and, after ruling out Covid and bacterial pneumonia, They were diagnosed Electronic cigarette or vaping product use-associated lung injury (EVALI).
EVALI has been a concern for years as the rate of e-cigarette use among youth has skyrocketed.
Public health reports show that about 2,800 patients were hospitalized due to EVALI in 2020, 15 percent of whom were adolescents, signaling the beginning of a small epidemic of EVALI cases across the United States.
The young woman suffered symptoms for a week before going to the hospital, including high fever with chills, cough, and shortness of breath at rest.
Before going to the hospital, she had been prescribed azithromycin, an antibiotic, for five days.
She did not undergo a CT scan or MRI, so doctors could not see the glassy opacities or fuzzy spots in her lungs, basing their decision to prescribe the drug on her symptoms, which mirrored those of a bacterial infection.
Vitreous opacities often occur along with consolidation in the lungs. Consolidation refers to thickening or swelling of lung tissue, which occurs when the air spaces in the lungs fill with fluid, pus, blood, or cells.
The morning she decided to go to the hospital, her breathing problems had reached their peak.
When she arrived, her heart rate was higher than normal, 120 beats per minute, and her respiratory rate was elevated, 26 breaths per minute, higher than the normal range (60-100 bpm). The standard respiratory rate is about 12 to 20 breaths per minute.
First introduced in the U.S. around 2007, e-cigarettes are now the most widely used tobacco product among U.S. youth, often marketed as a safer alternative to regular cigarettes.
She had a fever and doctors discovered she was hypoxemic, meaning her blood was not carrying enough oxygen.
Doctors put her on a ventilator, gave her more antibiotics and gave her medication to control her fever.
However, as no improvement was observed after 48 hours, they ruled out bacterial pneumonia and Covid.
Given the puzzling nature of his case, a pulmonologist was brought in and eventually asked if he used e-cigarettes.
The patient reported that she had been vaping e-cigarettes daily for the past month. She was diagnosed with lung damage caused by EVALI.
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EVALI is a respiratory illness that mimics other infections and is caused by inhaling toxic substances added to vaping liquid that induce a chemical type of pneumonia.
EVALI is a diagnosis of exclusion because there are no clear criteria for it.
Imaging findings usually show fuzzy spots in the lungs.
Treatment consists of steroids along with supportive care with oxygen and complete cessation of e-vaping.
Patients generally respond well to steroid treatment and the prognosis is generally good after diagnosis.
According to a CDC Research In the case of a 2019 EVALI outbreak, vitamin E acetate may be the cause. This compound has been detected in product samples tested by the FDA and state labs, as well as in lung fluid samples from EVALI patients tested by the CDC in several states.
Of note, vitamin E acetate has not been found in the lung fluid of individuals without EVALI.
Doctors gave the patient a high dose of a steroid called prednisone. Her respiratory symptoms improved and signs of lung inflammation decreased. Her blood oxygen levels also improved and she was able to leave the hospital.
She would recover fine as long as she stayed away from vapers.
High-potency e-cigarettes are extremely addictive. Of all young people who have tried them, nearly half became regular users, according to the CDC.
Doctors warned her not to vape again, saying the risk of EVALI recurring would be very high.
First introduced in the United States around 2007, e-cigarettes are now the most widely used tobacco product among youth in that country, often marketed as a safer alternative to regular cigarettes.
Among middle and high school students, 2.8 million (10 percent) reported Current use of a tobacco product such as a vape in 2023. Additionally, 2.13 million (7.7 percent) of students reported current use of e-cigarettes in 2023.
