Summary
Introduction:
This text discusses a case report of a patient with acute eosinophilic pneumonia (AEP) after using electronic cigarettes (e-cigarettes). The reader will learn about the potential relationship between e-cigarette use and AEP, as well as the clinical evaluation and diagnosis of this condition.
Key Points:
* The patient is a young, healthy female with no history of traditional cigarette smoking, drug use, or exposure to pulmonary irritants.
* She presented to the Emergency Room with fever, nonproductive cough, difficulty breathing, and pleuritic chest pain after using e-cigarettes for two months.
* Initial chest x-ray demonstrated right lower lung airspace consolidation consistent with pneumonia, and laboratory tests revealed significant leukocytosis with eosinophils making up 0.5% of the total.
* Overnight, the patient developed worsening respiratory failure, and repeat chest radiograph demonstrated increasing airspace opacities.
* A computed tomography pulmonary angiogram (CTPA) excluded pulmonary embolism, but found diffuse ground-glass patchy airspace disease and coalescing nodules.
* Bronchoscopy with bronchial alveolar lavage (BAL) revealed 26% eosinophils in the lavage fluid, and sputum and BAL cultures were negative for viral, fungal, and bacterial pathogens.
* The patient was diagnosed with AEP and started on methylprednisolone, showing significant improvement after two days.
* The text highlights the need for more research into the relationship between e-cigarettes and AEP, as e-cigarettes may promote pulmonary inflammation similar to traditional cigarette smoking.
Main Message:
The main message of this text is the potential link between e-cigarette use and AEP. Clinicians should consider AEP in patients with hypoxic respiratory failure and a history of e-cigarette use. As e-cigarette use becomes more prevalent, it may become a more common trigger of AEP. Further research is needed to determine the exact cause of e-cigarette induced AEP, including the role of the wide variety of vaping devices and fluid brands.
Citation
Arter, Zhaohui L., Amanda Wiggins, Caleb Hudspath, Adam Kisling, David C. Hostler, and Jordanna M. Hostler. “Acute Eosinophilic Pneumonia Following Electronic Cigarette Use.” Respiratory Medicine Case Reports 27 (2019): 100825. https://doi.org/10.1016/j.rmcr.2019.100825.
