A 23-year-old Man With Acute Lung Injury After Using a Tetrahydrocannabinol-containing Vaping Device

A Case Report

Anthony Lucero; Niklas Eriksson; Carli Nichta; Kimberly Sokol


J Med Case Reports. 2021;15(70) 

In This Article

Diagnostic Assessment

Laboratory studies revealed leukocytosis of 17.0 × 109/L with 93% neutrophils and an elevated lactic acid of 1.9 mmol/L. The findings of the patient's chemistry panel were unremarkable. His urine drug screen result was positive for cannabinoids and benzodiazepines. His erythrocyte sedimentation rate was slightly elevated at 63 mm/hour. His human immunodeficiency virus and hepatitis B and C virus test results were negative. A viral panel was obtained, which showed positive results for rhinovirus and enterovirus, but otherwise negative findings were reported. This patient's hospitalization occurred before the coronavirus disease 2019 (COVID-19) pandemic; therefore, no COVID-19 testing was available at the time. He had negative test results for antineutrophil antibodies, cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies, and myeloperoxidase. His echocardiogram demonstrated a left ventricular ejection fraction of 64%; otherwise, he had no effusion, no vegetation, or other acute findings. A plain chest x-ray (CXR) (Figure 2) demonstrated diffuse central predominant interstitial opacities. A computed tomographic (CT) angiogram of the chest was then obtained (Figures 3 and 4), which confirmed diffuse bilateral interstitial infiltrates, with no evidence of vascular injury or pulmonary embolism.

Figure 2.

Chest x-ray demonstrating diffuse central predominant interstitial opacities (black arrows)

Figure 3.

Axial view computed tomographic scan of the chest demonstrating diffuse central predominant interstitial opacities (black arrows)

Figure 4.

Sagittal view computed tomographic scan further demonstrating diffuse central predominant interstitial opacities (black arrows)