A rare case of acute eosinophilic pneumonia induced by vaping-associated lung injury: a case report

Abstract

A 17-year-old medically free female developed a sudden onset shortness of breath for one-day duration associated with pleuritic left sided chest pain and fever. She denied prior respiratory infections and systematic review was unremarkable. She recently started vaping 20 days prior to the presentation. Family history was significant for atopy, and no significant past surgical history. Initial vital signs and physical examination findings showed temperature: 39.5, (HR):111,(RR): 23,(BP): 110/72,(SpO2):96% on room air. As the patient was tachypneic with progressive hypoxia (CTA) was done to rule out PE, which showed multiple scattered peripheral ground-glass consolidation suggestive of an inflammatory process. A course of antibiotics was started for atypical pneumonia, but the symptoms failed to improve and progressed to hypoxemic respiratory failure that required high flow oxygen. Flexible bronchoscopy with bilateral BAL was performed revealing high eosinophil with result of: 84%. Therefore, AEP was diagnosed. AEP was diagnosed, and oral steroid was prescribed,the patient came back for follow up. Her symptoms improved and (HRCT) showed interval resolution of the bilateral opacity which consistent with the treatment response. AEP is a rare and serious condition characterized by nonproductive cough, dyspnea, and fever that typically present in less than four weeks. Management of AEP involves administration of high-dose systemic glucocorticoids intravenously until the respiratory failure resolves, followed by an oral steroid taper.