EVALI

 Q: EVALI can occur without respiratory symptoms?

A) True

B) False

Answer: A

EVALI stands for E-cigarette/Vaping product use Associated Lung Injury. In the last 3 years, a significant rise has been amongst young individuals for its abuse. Interestingly, despite EVALI signs apparent on chest-x-ray, there may not be any respiratory symptoms. In some cases, in the initial phase gastrointestinal (GI) symptoms may be pre-dominant with nausea, vomiting, diarrhea, and abdominal pain. 

In typical cases, respiratory symptoms include shortness of breath (SOB), cough, generalized chest or pleuritic chest pain, and rarely hemoptysis. Fever, chills, tachycardia, tachypnea, and hypoxemia are common. 

There is no specific guideline available for treatment but most physicians prefer empiric antibiotics and a short course of steroids.

#pulmonology

#toxicology

References:

1. Matta P, Hamati JN, Unno HL, Fox MD. E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) Without Respiratory Symptoms. Pediatrics 2020; 145. 

2. Layden JE, Ghinai I, Pray I, et al. Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Final Report. N Engl J Med 2020; 382:903. 

3. Rao DR, Maple KL, Dettori A, et al. Clinical Features of E-cigarette, or Vaping, Product Use-Associated Lung Injury in Teenagers. Pediatrics 2020; 146.