Abstract
There have been increasing reports of electronic cigarette (e-cigarette) or vaping use-associated lung injury (EVALI), and the evolving literature demonstrates that the solvents used to dissolve flavors, including vitamin E, may be responsible, at least in part, for the injuries associated with this form of smoking. We present the case of a 26-year-old, otherwise healthy, African American male with a history of heavy use-cigarette use who presented with pleuritic chest pain. He was found to be septic and developed a rapidly accumulating pleural effusion with loculations during his hospitalization. He eventually underwent a thoracotomy due to his deteriorating respiratory status. This case highlights the importance of physician awareness regarding the growing evidence base suggesting that electronic cigarettes and vaporized tobacco products are not as safe as they have been perceived to be. Physicians should screen for and advise patients regarding the risks associated with the use of such products.