Abstract
EVALI and COVID‐19 share similar clinical and imaging features. Assessing the vaping or e‐cigarette use history and conducting urine toxicology tests for high‐risk patients are important with increasing COVID‐19 cases in young adults.
Keywords: COVID‐19, E‐cigarette or vaping use‐associated lung injury, EVALI
EVALI and COVID‐19 share similar clinical and imaging features. Assessing the vaping or e‐cigarette use history and conducting urine toxicology tests for high‐risk patients are important with increasing COVID‐19 cases in young adults.
1. CASE DESCRIPTION
A 20‐year‐old unvaccinated man presented with a 3‐day history of dyspnea and fever. He was tachycardic (heart rate of 160/min) and tachypneic (respiratory rate of 20/min) with oxygen saturation of 93% on room air, body temperature of 37.9°C, and bibasilar crackles were noted. Initial tests were remarkable for leukocytosis (19.0 × 103/μL) and bilateral diffuse consolidation on chest radiography. Chest computed tomography (CT) with contrast showed diffuse, bilateral subsegmental ground‐glass opacities (Figure 1). The SARS‐CoV‐2 nasopharyngeal swab polymerase chain reaction test was negative. He admitted to occasionally using THC‐containing e‐cigarettes. Urine toxicology test was positive for THC. The Pneumococcal and Legionella urine antigen tests, rapid influenza tests, respiratory viral panel tests, Mycoplasma IgM antibody, HIV, and blood cultures were negative. We diagnosed him with e‐cigarette or vaping use‐associated lung injury (EVALI).
FIGURE 1.
Chest computed tomography with contrast enhancement shows bilateral patchy ground‐glass pulmonary opacities, primarily with a peripheral distribution
2. DISCUSSION
EVALI and COVID‐19 have similar substantial clinical features. Although COVID‐19 was the most likely diagnosis, given the patient's unvaccinated status, COVID‐19 test was negative. Through direct questioning regarding e‐cigarette, we could suspect EVALI as a possible diagnosis. This case highlights the diagnostic challenge of EVALI, especially in the current context of the COVID‐19 pandemic. The median age of EVALI is reported as 21 years old (range 15–53). 1 Assessing the social history, including vaping or e‐cigarette use and conducting urine toxicology tests for those with high risk, is essential with increasing COVID‐19 cases among young adults. 2
CONFLICTS OF INTEREST
None.
AUTHOR CONTRIBUTIONS
Y Hoshina collected data and information and also writer of the present work.
CONSENT
Informed consent was obtained from the patient.
ACKNOWLEDGEMENT
Nothing to disclose.
Hoshina Y. E‐cigarette or vaping product use‐associated lung injury: A great COVID‐19 mimicker in young adult. Clin Case Rep. 2021;9:e05016. 10.1002/ccr3.5016
DATA AVAILABILITY STATEMENT
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
REFERENCES
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.