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
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.
Q: After finding out The cause could be e-cigarettes. Have you contacted the Centers for Disease Control and Prevention or the Food and Drug Administration or any other regulatory agency to inform them?
We do not have. At the time, we thought it appropriate to include it in the medical literature. And if other case reports were brought from other parts of the country, we would have more of a collection of results that could justify that research agencies [getting a] better understand the cause of the disease [about].
Q: What federal agency would you report if you did?
In 2015, of course, the FDA still regulated cigarettes, but I believe the government had not yet decided who would regulate steam products. I'm sure it was unclear who we should call.
Q: Did you or your team think this was a one-time event when you witnessed it?
We Really Sick It It would not be a one-time event, and what we have usually called a "wake" health event in public health. This was an example of a respiratory disease that can be caused by this exposure, and that probably was not the first case ever seen, nor would it be the last.
Q: Was this the first case you saw at your institution?
To our knowledge, it was our first case, but we are humble enough to note that we may have overlooked some other cases that we have interpreted as [as] viral or bacterial pneumonia.
Q: Have you seen more cases since then?
I know we have seen a case [of alveolar hemorrhage syndrome] that we have published, and when questioning some colleagues we probably also [cases of] Cryptoge saw well-organized pneumonia as well as lipoid pneumonia and acute eosinophilic pneumonia. Yes, we've certainly seen at least four forms of lung disease through vaping.
Q: If your team saw this in 2015, is it possible that it has happened in the four years since then and people just do not know it?
I have every reason to believe that we were by no means the first to see it.
And I do not think we were the first ones to report it. I think there were some clusters in Wisconsin and some other places in the US. I also know that the Japanese were very interested. You probably have at least four or five articles in the medical literature about vapor-induced lung injuries.
Q: Do you have a theory about what could cause the cases of lipoid pneumonia? Do you think there are certain chemicals that are irritating?
We need a strong multidisciplinary team to understand the true etiology and cause of lung injury during inhalation. I think it could be any number of components in the mixes. The lungs generally do not like oil, and perhaps the most specific compound recently investigated is diacetyl, which has been studied for popcorn-flavored lung diseases.
Q: Do these cases address your way of changing patients?
Yes, we are very carefully looking for a history of Vaping. … I think it's pretty important to understand if they're using inhaled agents or vapors that could lend the lungs new toxicity.
Q: Will these diseases have long-term health effects?
Inhaled injury can cause an acute lung injury that is life-threatening and that may survive and have no long-term consequences [condition]. However, there is a possibility that long-term use [e-cigarette] may produce more insidious or more chronic diseases that may not be fully recovered.
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