Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a Teenager

A 17-year-old previously healthy male was admitted to the hospital for intractable and persistent vomiting, fever, cough, abdominal pain, and intermittent diarrhea and dehydration. He presented with severe chest pain and O2 desaturations up to 80% on room air. An infectious (including a nasopharynge...

Full description

Saved in:
Bibliographic Details
Main Authors: Amee A. Amin, Erica Haught, Youmna Mousattat
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2020/8822362
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832550893006880768
author Amee A. Amin
Erica Haught
Youmna Mousattat
author_facet Amee A. Amin
Erica Haught
Youmna Mousattat
author_sort Amee A. Amin
collection DOAJ
description A 17-year-old previously healthy male was admitted to the hospital for intractable and persistent vomiting, fever, cough, abdominal pain, and intermittent diarrhea and dehydration. He presented with severe chest pain and O2 desaturations up to 80% on room air. An infectious (including a nasopharyngeal swab), GI, and cardiac workup was completed and was negative except for elevated inflammatory markers with a C-reactive protein (CRP) level of 261 mg/L, erythrocyte sedimentation rate (ESR) of 53 mm/hr, and a D-dimer level of 0.93 mcg/ml. Chest X-ray showed diffuse multifocal infiltrates. The patient was treated with ceftriaxone and azithromycin initially for a suspected pneumonia. He was also started on 4L of nasal cannula O2 supplementation. Due to persistent hypoxic respiratory failure, worsening respiratory distress clinically, with tachypnea and retractions, and lab findings of elevated D-dimer, a chest CT was performed to rule out a pulmonary embolism (PE). Computed tomography (CT) findings were negative for PE but notable for diffuse airspace opacities, primarily within the lower lobes, with a ground-glass appearance concerning for ARDS. Upon further investigation of the social history, the patient admitted to vaping nicotine products for the past 4 years and tetrahydrocannabinol (THC) products within the last several months. He was immediately started on prednisone 30 mg BID for a diagnosis of e-cigarette or vaping product use-associated lung injury (EVALI) and started showing clinical improvement. The patient was able to be weaned off of supplemental oxygen to room air, and clinical symptoms of respiratory distress began to improve over the next 24 hours.
format Article
id doaj-art-2c8077bae42247f3b269e4ebdebcd31b
institution Kabale University
issn 2090-6803
2090-6811
language English
publishDate 2020-01-01
publisher Wiley
record_format Article
series Case Reports in Pediatrics
spelling doaj-art-2c8077bae42247f3b269e4ebdebcd31b2025-02-03T06:05:29ZengWileyCase Reports in Pediatrics2090-68032090-68112020-01-01202010.1155/2020/88223628822362Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a TeenagerAmee A. Amin0Erica Haught1Youmna Mousattat2Charleston Area Medical Center Women & Children’s Hospital, Charleston, WV, USAWest Virginia University School of Medicine, Morgantown, WV, USACharleston Area Medical Center Women & Children’s Hospital, Charleston, WV, USAA 17-year-old previously healthy male was admitted to the hospital for intractable and persistent vomiting, fever, cough, abdominal pain, and intermittent diarrhea and dehydration. He presented with severe chest pain and O2 desaturations up to 80% on room air. An infectious (including a nasopharyngeal swab), GI, and cardiac workup was completed and was negative except for elevated inflammatory markers with a C-reactive protein (CRP) level of 261 mg/L, erythrocyte sedimentation rate (ESR) of 53 mm/hr, and a D-dimer level of 0.93 mcg/ml. Chest X-ray showed diffuse multifocal infiltrates. The patient was treated with ceftriaxone and azithromycin initially for a suspected pneumonia. He was also started on 4L of nasal cannula O2 supplementation. Due to persistent hypoxic respiratory failure, worsening respiratory distress clinically, with tachypnea and retractions, and lab findings of elevated D-dimer, a chest CT was performed to rule out a pulmonary embolism (PE). Computed tomography (CT) findings were negative for PE but notable for diffuse airspace opacities, primarily within the lower lobes, with a ground-glass appearance concerning for ARDS. Upon further investigation of the social history, the patient admitted to vaping nicotine products for the past 4 years and tetrahydrocannabinol (THC) products within the last several months. He was immediately started on prednisone 30 mg BID for a diagnosis of e-cigarette or vaping product use-associated lung injury (EVALI) and started showing clinical improvement. The patient was able to be weaned off of supplemental oxygen to room air, and clinical symptoms of respiratory distress began to improve over the next 24 hours.http://dx.doi.org/10.1155/2020/8822362
spellingShingle Amee A. Amin
Erica Haught
Youmna Mousattat
Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a Teenager
Case Reports in Pediatrics
title Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a Teenager
title_full Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a Teenager
title_fullStr Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a Teenager
title_full_unstemmed Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a Teenager
title_short Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a Teenager
title_sort do not huff puff or vape that stuff interstitial airspace disease in a teenager
url http://dx.doi.org/10.1155/2020/8822362
work_keys_str_mv AT ameeaamin donothuffpufforvapethatstuffinterstitialairspacediseaseinateenager
AT ericahaught donothuffpufforvapethatstuffinterstitialairspacediseaseinateenager
AT youmnamousattat donothuffpufforvapethatstuffinterstitialairspacediseaseinateenager