A young female vaper presented with insidious onset cough, progressive dyspnoea on
exertion, fever, night sweats and was in respiratory failure when admitted to hospital.
Clinical examination was unremarkable. Haematological tests revealed only thrombocytopenia,
which was long standing, and her biochemical and inflammatory markers were normal.
Chest radiograph and high-resolution CT showed diffuse ground-glass infiltrates with
reticulation. She was initially treated with empirical steroids and there was improvement
in her oxygenation, which facilitated further tests. Since the bronchoscopy and high-volume
lavage was unyielding, a video-assisted thoracoscopicsurgical biopsy was done later
and was suggestive of lipoid pneumonia. The only source of lipid was the vegetable
glycerine found in e-cigarette (EC). Despite our advice to quit vaping, she continued
to use EC with different flavours and there is not much improvement in her clinical
and spirometric parameters.