Smoky Diagnosis: Importance of Patient History in Vaping Associated Lung Injury

E-cigarette or vaping use associated lung injury (EVALI) recently became a common cause of respiratory illness. The pathophysiology of EVALI is relatively unknown, and thus the disease remains a diagnosis of exclusion. There are no specific tests or markers that exist, although there is some belief that Vitamin E acetate is strongly linked to the increase in EVALI cases. Immediate recognition of EVALI patients is critical in order to reducing severe outcomes. For these cases, the importance of a complete patient interview is emphasized and necessary for diagnosis. We present a case of a young patient presenting with hypoxic respiratory failure due to EVALI, in which diagnosis was delayed due to incomplete patient history.