Wilhite Rodger, Patel Tarang, Karle Ethan, Shankar Shyam, Krvavac Armin
Pulmonary, Critical Care and Environmental Medicine, University of Missouri Health Care, Columbia, USA.
Internal Medicine, University of Missouri Health Care, Columbia, USA.
Cureus. 2019 Dec 31;11(12):e6519. doi: 10.7759/cureus.6519.
Vaping involves the use of a device to deliver aerosolized nicotine and tetrahydrocannabinol (THC) oils to the lungs. Vaping continues to increase in popularity; however, because it is a novel drug delivery system there is little evidence regarding its safety and long-term consequences. Here, we present a 22-year-old Caucasian male who was admitted with acute hypoxic respiratory failure and massive hemoptysis. Contrasted computed tomography of the chest demonstrated ground glass opacities throughout all lung fields and bilateral pulmonary emboli. Bronchoalveolar lavage revealed increased red blood cell counts in serial aliquots, consistent with the diagnosis of diffuse alveolar hemorrhage (DAH). An extensive workup did not reveal an etiology for the DAH. However, further history was obtained, and the patient divulged daily vaping of THC. E-cigarette, or vaping, product use associated lung injury (EVALI) consists of a myriad of different lung injury patterns. Our case illustrates an uncommon presentation of EVALI with DAH and multiple pulmonary emboli.
吸电子烟涉及使用一种装置将雾化的尼古丁和四氢大麻酚（THC）油输送到肺部。吸电子烟的 popularity 持续上升；然而，由于它是一种新型药物输送系统，关于其安全性和长期后果的证据很少。在此，我们报告一名22岁的白人男性，他因急性低氧性呼吸衰竭和大量咯血入院。胸部增强计算机断层扫描显示所有肺野均有磨玻璃影和双侧肺栓塞。支气管肺泡灌洗显示连续几份标本中红细胞计数增加，符合弥漫性肺泡出血（DAH）的诊断。广泛的检查未发现DAH的病因。然而，进一步询问病史后，患者透露每天吸含THC的电子烟。电子烟或吸电子烟产品使用相关肺损伤（EVALI）包括多种不同的肺损伤模式。我们的病例说明了EVALI伴DAH和多发性肺栓塞的一种罕见表现。
