Severe Vaping Product Use‑Associated Lung Injury in a Healthy Young Adult: A Case Report

Vaping product use-associated lung injury is a recently recognized respiratory illness that can occur in users of e-cigarettes or vaping products, including those marketed as nicotine‑free. We describe a previously healthy, 22‑year‑old male, non‑smoker who presented with progressive shortness of breath, non‑productive cough, pleuritic chest pain, low‑grade fever, and fatigue. He reported daily use of a flavored nicotine‑free vaping device for eight months, with increased use in the preceding month, including cartridges purchased from unregulated online sources. Examination revealed hypoxemia, tachypnea, and diffuse inspiratory crackles. Laboratory studies showed leukocytosis and elevated inflammatory markers, while infectious and autoimmune evaluations were negative. High‑resolution computed tomography demonstrated bilateral ground‑glass opacities with dependent predominance and subpleural sparing. A presumptive diagnosis of vaping product use-associated lung injury was made. The patient improved rapidly with supplemental oxygen and corticosteroid therapy, and at the three‑month follow‑up, he had complete symptom resolution, normal pulmonary function, and near‑complete radiographic recovery. This case highlights that severe lung injury can occur in healthy young adults using nicotine‑free vaping products from informal sources, emphasizing the need for thorough vaping histories, careful exclusion of alternative diagnoses, and public health interventions to regulate product safety.