Adhikari Ramesh, Koritala Thoyaja, Gotur Raghavender, Malayala Srikrishna V, Jain Nitesh K
Hospital Medicine, Franciscan Health, Lafayette, USA.
Geriatrics, Brown University, Providence, USA.
Cureus. 2021 Feb 24;13(2):e13541. doi: 10.7759/cureus.13541.
The use of electronic cigarettes among the young adult and adolescent population has increased over the past decade. Vaping is the process of inhaling an aerosol that is produced by heating a liquid or wax containing substances, such as nicotine, cannabinoids (e.g., tetrahydrocannabinol (THC), cannabidiol), flavoring, and additives (e.g., glycerol, propylene glycol) using an e-cigarette. A multistate epidemic associated with vaping prompted the Centers for Disease Control and Prevention (CDC) to issue an official health advisory on e-cigarette or vaping product use-associated lung injury (EVALI). EVALI is a diagnosis of exclusion with no specific diagnostic test. We present a case of EVALI before the COVID-19 pandemic time in a 23-year-old immunocompetent male student with an eight-year history of vaping. He presented to the emergency department with fever, shortness of breath, tachypnea, nausea, and diarrhea. The patient had no past medical history. The patient denied illicit drug abuse or known drug allergies. The patient was admitted with a diagnosis of sepsis and pneumonia. The patient's urine drug screen was positive for cannabinoids with a history of vaping. Community-acquired pneumonia due to Legionella, Pneumococcal, Mycoplasma bacteria was ruled out. Influenza A/B, Parainfluenza, Rhino, and Adenoviruses were negative. A computed tomographyscan of the chest showed bilateral infiltrates. He was treated with high dose steroids, empiric antibiotics, high flow oxygen and managed in ICU for seven days. The patient was discharged on tapering doses of steroid and counseled to quit vaping. EVALI outbreak is strongly linked to vitamin E acetate in vaping products. EVALI is a diagnosis of exclusion with a history of vaping and responds well to steroids.
在过去十年中，电子烟在青年和青少年人群中的使用有所增加。吸电子烟是指使用电子烟吸入通过加热含有尼古丁、大麻素（如四氢大麻酚（THC）、大麻二酚）、调味剂和添加剂（如甘油、丙二醇）的液体或蜡所产生的气溶胶的过程。与吸电子烟相关的多州疫情促使美国疾病控制与预防中心（CDC）就电子烟或吸电子烟产品使用相关的肺损伤（EVALI）发布了官方健康咨询。EVALI是一种排除性诊断，没有特定的诊断测试。我们报告一例在2019冠状病毒病大流行之前发生的EVALI病例，患者为一名23岁免疫功能正常的男学生，有八年吸电子烟史。他因发热、呼吸急促、呼吸过速、恶心和腹泻就诊于急诊科。该患者既往无病史。患者否认非法药物滥用或已知药物过敏。患者因脓毒症和肺炎入院。患者的尿液药物筛查显示大麻素呈阳性，有吸电子烟史。排除了由嗜肺军团菌、肺炎球菌、支原体细菌引起的社区获得性肺炎。甲型/乙型流感、副流感、鼻病毒和腺病毒检测均为阴性。胸部计算机断层扫描显示双侧浸润。他接受了高剂量类固醇、经验性抗生素、高流量氧气治疗，并在重症监护病房治疗了七天。患者出院时逐渐减少类固醇剂量，并接受了戒烟咨询。EVALI疫情与电子烟产品中的醋酸维生素E密切相关。EVALI是一种有吸电子烟史的排除性诊断，对类固醇治疗反应良好。
