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VAPI: Vaping Associated Pulmonary Injury

Mizuho Morrison, DO and Solomon Behar, MD

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Given the recent spike of VAPI (vaping associated pulmonary injury) cases, our HIPPO medical editorial team review the clinical presentation and latest management recommendations for this lung disease. Mizuho Morrison and Sol Behar discuss a recent case, and review the hot-off-the-press published CDC health alert. Take a listen!


  • There has been a recent explosion in vape associated pulmonary injury, with serious morbidity and mortality.

  • VAPI has been more commonly associated with THC-containing products ,although a wide variety of nicotine containing products and devices have been reported.

  • Symptoms: 

    • Constitutional symptoms (100%)

    • Respiratory distress and cough (98%)

    • GI symptoms: nausea, vomiting, diarrhea (80%)

    • Fever (30%)

  • Diagnosis: Vaping in past 90 days, bilateral pulmonary infiltrates on imaging, Ground-glass appearance noted on CT chest. Absence of detectable bacterial/viral infection. 

  • Treatment: 

    • Respiratory support

    • Steroids may be beneficial

    • Antibiotics alone do not appear to help as this is not an infectious process, rather an inflammatory one. However given initial mixed presentation, it is not unreasonable to initiate antibiotics until pneumonia is ruled out and diagnosis is confirmed. 



  1. Layden JE1,Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Preliminary Report. N Engl J Med. 2019 Sep 6. 




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