anaerobic Necrotizing Pneumonia: another Potential Life-threatening Complication of Vaping?

Introduction:
This text discusses a case report of an adolescent girl who developed severe necrotizing pneumonia caused by Fusobacterium necrophorum after frequent electronic cigarette (vaping) use. The authors propose a novel mechanism for the pathogenesis of her infection, including possible contributions of her vaping behavior. They suggest that vaping may be associated with secondary effects that allow the pathogen to gain entry to the lungs by inhalation during e-cigarette use, leading to anaerobic necrotizing pneumonia.

Key Points:

* The patient is a 15-year-old girl with a history of daily vaping of nicotine for 9 months, going through a pre-filled nicotine cartridge every 1-2 days.
* She presented to the emergency department with cough, shortness of breath, fever, vomiting, and diarrhea.
* Blood cultures grew Fusobacterium necrophorum, an uncommon but well-known cause of anaerobic pneumonia.
* The patient had no preceding pharyngeal infection or Doppler ultrasonographic evidence for the presence of deep neck vein thrombi.
* The authors propose that the patient's vaping led to chronic irritation of her pharyngeal mucous membranes, facilitating direct inhalation of Fusobacterium necrophorum from her colonized oropharynx.
* Once inhaled, vaping-associated chronic irritation of the patient's airways likely contributed to the permissive conditions needed for the bacteria to establish a highly destructive infection.
* The patient was hospitalized for 10 days, required supplemental oxygen, and was discharged to complete 21 days of intravenously administered piperacillin plus tazobactam.

Main Message:
The text highlights the potential life-threatening complications of vaping, including severe anaerobic necrotizing pneumonia caused by Fusobacterium necrophorum. The authors suggest that vaping may be associated with secondary effects that allow the pathogen to gain entry to the lungs by inhalation during e-cigarette use. The study emphasizes the importance of considering vaping as a possible risk factor for severe lung infections and the need for further research to understand the relationship between vaping and lung infections.

El Chebib h, Mcarthur K, Gorbonosov M, Domachowske JB. anaerobic Necrotizing Pneumonia: another Potential Life-threatening Complication of Vaping? Pediatrics. 2020;145(4). doi:10.1542/peds.2019-3204