Acute eosinophilic pneumonia caused by nicotine‐free vaping in an adolescent patient: A case report

Takigawa, Yuki; Sato, Kyosuke; Inoue, Ayumi; Nagae, Momoka; Inoue, Tomoyoshi; Onishi, Kiriko; Mitsumune, Sho; Watanabe, Hiromi; Kudo, Kenichiro; Satô, Akiko; Shibayama, Takuo

doi:10.1002/rcr2.961

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…The primary histopathologic lesion in EVALI has been acute fibrinous pneumonitis, diffuse alveolar damage (DAD), organizing pneumonia, and bronchiolitis (Butt et al, 2019). Although uncommon, AEP has been reported in a few patients with EVALI during the epidemic in the US and before that (Thota and Latham, 2014;Kamada et al, 2016;Mull et al, 2020;Puebla Neira et al, 2020;Wolf and Richards, 2020;Takigawa et al, 2022;Bonnier et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

Vaping Associated Acute Eosinophilic Pneumonia: A Clinical and Radiologic Mimicker of COVID-19

Bonnier,

Nida,

Chong

et al. 2023

Prague Med. Rep.

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Acute eosinophilic pneumonia (AEP) is a rare cause of respiratory failure. It is primarily a disease of smokers, either a new smoker or an existing one with a recent increase in cigarette consumption. Other risk factors include toxic gas exposure, inhalational illicit drugs, and smoking marijuana. AEP has also been reported in patients with e-cigarette or vaping associated lung injury (EVALI). We present the case of a 20-year-old male who presented to the hospital with acute respiratory failure. The patient has been vaping heavily for the past three months and started smoking three days before presenting to the emergency department. He was hypertensive, tachycardic, tachypneic, and required high-flow nasal cannula to maintain SpO2 > 92%. His condition deteriorated in the first 24 hours following hospitalization requiring noninvasive positive pressure ventilation. Bronchoalveolar lavage revealed an eosinophil count of 36%. Bronchoalveolar lavage (BAL) cytology revealed lipid-laden macrophages. He was diagnosed with AEP due to EVALI, and the patient was treated with high dose corticosteroid with subsequent improvement. Before the bronchoscopic evaluation, the clinical and radiologic findings were consistent with COVID-19, and the patient was tested twice for SARS-CoV-2 PCR. In the appropriate clinical setting, AEP should be considered in the differential diagnoses of community-acquired pneumonia, acute respiratory distress syndrome (ARDS), and COVID-19, especially in this pandemic era.

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