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Years ago, this doctor combined a mysterious lung disease with vaping



Dr. John E. Parker worked in a hospital in West Virginia in 2015, when a 31-year-old patient with acute respiratory problems was admitted. A team of physicians eventually surmised that their mysterious case of lipoid pneumonia was related to vaporizing, and was not sure they had seen it before. They were so intrigued that they presented a case report – a kind of medical document about unusual or provocative patient findings. Such reports can be used as an appeal to the medical community to watch, though sometimes they raise more questions than provide answers.

This summer, almost four years later, federal officials began investigating a national outbreak of serious lung disease related to vaping, which has hit more than 1

50 patients in 16 states. In an interview, Parker, a professor of intensive care and sleep medicine at West Virginia University, described what happened.

Q: Can you describe what symptoms the patient had on arrival?

We would look at it They are considered classics for the so-called Vaping-associated lung disease. She was very, very short of breath and had a cough, and of course we were very afraid that she might have pneumonia or some other acute respiratory illness. And then she was so sick that she had to be intubated.

Q: What happens in such cases?

We are looking for things like [hemorrhage] or an active infection. And then for lipid-containing macrophages. And then we usually start with antibiotics [and a]which are low-dose, and then assist the patient with a respirator, oxygen, and nutrition. And then just wait and see if other cultures come back to prove anything other than you might have thought.

Early on, we had the impression that this was an unusual case and that there might not be a common viral or bacterial infection.

Q: How did you discover that the cause of their lipid pneumonia is e-cigarettes?

It is an exclusion diagnosis. We excluded others [options] and it became the most likely cause.

We were convinced enough that the case was unveiled this year at the annual meeting of the American College of Chest Physicians.


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