As investigations continue into the ongoing outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) cases in the United States, a new type of vaping-related injury is being reported in Canada.
A team of authors from Ontario and Toronto is reporting that a type of vaping-related illness, similar to ‘popcorn worker’s lung’ has been identified in a 17-year-old Canadian.
The previously healthy teenager presented with intractable cough, progressive dyspnoea and malaise after vaping flavoured e-liquids and tetrahydrocannabinol intensively. Initial physical examination showed fever, tachycardia, hypoxaemia and bibasilar inspiratory crackles on lung auscultation, with computed tomography of the chest showing diffuse centrilobular “tree-in-bud” nodularity, consistent with acute bronchiolitis.
The adolescent subsequently required intubation, invasive mechanical ventilation and venovenous extracorporeal membrane oxygenation (ECMO) for refractory hypercapnia.
His condition improved with high-dose corticosteroids, and he was eventually discharged home after 47 days in hospital.
The authors noted that several months after discharge his exercise tolerance remained limited, while pulmonary function tests showed persistent, fixed airflow obstruction with gas trapping.
After ruling out other causes, the authors suspect flavoured e-liquids as the cause and say the case may represent vaping-associated bronchiolitis obliterans.
The report is published in the Canadian Medical Association Journal.