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

Therapeutic Interventions

Because the patient remained hypoxic without supplemental oxygen, he was admitted to the medical floor for further management and respiratory care. Intravenous vancomycin and piperacillin-tazobactam were initiated on the basis of concerns for pneumonia.

On hospital day 2, a rapid response was called for worsening tachypnea and hypoxia. The patient was found to have oxygen saturation of only 90% on 15 L via nonrebreather. He was therefore intubated for impending respiratory failure and was transferred to the intensive care unit (ICU). Antibiotic coverage was switched to meropenem, levofloxacin, and aztreonam for further broad-spectrum coverage, given the extent of the bilateral infiltrates and his worsening hypoxia and respiratory status. Fluconazole was also added for fungal coverage until his coccidiomycosis serology was found to be negative, and the medication was subsequently discontinued. Intravenous corticosteroids were then initiated. A bronchoscopy was performed, which revealed scattered small mucosal ulcerations without purulent secretions, masses, or obstruction. On hospital day 3, the patient self-extubated but remained in the ICU for 4 days for further respiratory monitoring. During this time, his oxygen requirement was weaned, and on hospital day 7, he was transferred to the medical floor. He was ultimately discharged to home on hospital day 8 after his respiratory distress and hypoxia had resolved. He was counseled on drug cessation and smoking cessation prior to discharge.