E-cigarette or vaping product-use-associated lung injury (EVALI): A case report of a pneumonia mimic with severe leukocytosis and weight loss

E-cigarette or vaping product-use-associated lung injury is a disease process obtained from smoke inhalation with electronic delivery systems and typically presents with shortness of breath, cough, and fever, not unlike pneumonia. Our patient presented with similar symptoms, and his case went unrecognized through several emergency department visits. The pathophysiology is similar to chemical pneumonitis and can cause significant morbidity and mortality, particularly when it goes unrecognized. It often presents with a pneumonia-like picture and may be treated as such. The distinguishing and controversial treatment for this disease is systemic glucocorticoids, which are not often given in pneumonia. This case is unique for the significant leukocytosis found on laboratory testing and profound weight loss associated with his course of illness. Emergency medicine providers should be vigilant in recognizing this illness to prevent progression of this disease.