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Vaping-Related Lung Illnesses Subject to Risk of Misdiagnosis

January 20, 2020

The serious lung injuries that have been linked with use of vaping products can often be mistaken for other illnesses, leading to the potential for dangerous progression of the disease, suggests a case report published Jan. 11 in the Journal of the American College of Emergency Physicians.

The case report documented the experience of a 20-year-old male who visited three hospital emergency departments before being diagnosed with a lung injury associated with e-cigarette use. Following the correct diagnosis, he was started on prednisone, showed rapid improvement, and was taken off oxygen within 48 hours.

The young adult had been diagnosed with a viral illness after the first emergency visit and bilateral pneumonia after the second visit, but he failed to improve on a course of antibiotics during an inpatient admission after the second visit and left the hospital against medical advice.

The man's symptoms prior to presenting for emergency care had included a coarse-sounding cough, intermittent fever and weight loss of more than 20 pounds. Several months before becoming ill, he had begun vaping THC in cartridges that had been given to him by a friend.

Study lead author Kaitlyn Works, MD, an emergency physician at Vanderbilt University Medical Center, said in a news release that during the current flu season, symptoms that are actually consistent with vaping-related illness “may resemble pneumonia and become more dangerous or deadly when left untreated.”

The case report states that as vaping-associated lung illnesses become more widespread, “it will be important for emergency physicians to take a thorough social history and to recognize the historical and radiologic features consistent with this disease process. Prompt recognition is important, because the disease often progresses in severity quite rapidly.”

As of Jan. 14, the Centers for Disease Control and Prevention (CDC) reports that there have been more than 2,600 hospitalized cases of lung injury associated with use of vaping products. There have been 60 confirmed deaths in 27 states.

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