Public Release: 

Case report finds acute hypersensitivity pneumonitis in patient using e-cigarettes

Report points to possibility of diacetyl, a flavoring agent known to cause bronchiolitis obliterans and used in some e-cigarettes, as the causative agent

American College of Chest Physicians

[CORRECTION] An October 19, 2015 version of this press release stated in error a diagnosis of bronchiolitis obliterans. Researchers reported a diagnosis of inhalational injury, suspected acute hypersensitivity pneumonitis, related to e-cigarette use.

MONTRÉAL (October 20, 2015)- Researchers from VA Hospital in White River Junction, Vermont will present a case report of acute inhalation lung injury related to the use of e-cigarettes and a flavored e-cigarette liquid containing diacetyl.

The case study presented involves a 60-year-old cigar-smoking male who was admitted with weakness, chills and cough. No significant radiologic abnormalities were found, but he was treated with ceftriaxone and azithromycin and discharged after three days feeling normal. One month later the patient presented with similar symptoms. Additionally, he had a fever and was hypoxemic. On examination, he had bilateral upper lung zone crackles and bilateral upper lobe predominant ground glass opacities on chest CT. After further questioning, the patient reported using strongly-flavored e-cigarettes prior to each admission. The patient was diagnosed with inhalation injury and suspected acute hypersensitivity pneumonitis related to electronic cigarette use. The patient did not use e-cigarettes again and had no further symptoms. A follow up CT scan and pulmonary function test at 3 months were normal.

"The use of e-cigarettes in the United States is increasing rapidly and the flavorings used, many of which contain diacetyl, may be harmful. This case adds to the growing body of research indicating e-cigarettes pose a health risk," said Dr. Graham Atkins, of White River Junction VA Hospital, lead researcher.


Further results will be shared during CHEST 2015 on Tuesday, October 27, at 1:30 pm at Palais des congrès de Montréal, Exhibit Hall. The study abstract can be viewed on the CHEST website.

CHEST 2015 is the 81st annual meeting of the American College of Chest Physicians, held October 24-28, 2015, in Montréal, Canada. The American College of Chest Physicians, publisher of the journal CHEST, is the global leader in advancing best patient outcomes through innovative chest medicine education, clinical research, and team-based care. Its mission is to champion the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. It serves as an essential connection to clinical knowledge and resources for its 18,700 members from around the world who provide patient care in pulmonary, critical care, and sleep medicine. For more information about CHEST 2015, visit, or follow the CHEST meeting hashtag, #CHEST2015, on social media.

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