Patricia Kritek, MD reviewing Layden JE et al. N Engl J Med 2019 Sep 6 Maddock SD et al. N Engl J Med 2019 Sep 6 Christiani DC. N Engl J Med 2019 Sep 6 Report of Newly Identified E-Cigarette–Related Lung Disease The following NEJM Journal Watch summary explains the study and results in more detail: It is critical that healthcare workers remain alert for new cases and report them to local public health authorities as part of the effort to identify the underlying etiology of this apparently new illness. To support healthcare workers, the CDC has drafted a case definition (see table above) for the purposes of disease surveillance and has published interim guidance for the workup, diagnosis, and management of suspected EVALI based on reported cases. Overall, 72% of patients had been seen in an outpatient setting prior to being hospitalized, highlighting the importance of identifying EVALI earlier. At this stage of the outbreak, the most important role primary care physicians play is heightened vigilance for possible cases. This uncertainty is further complicated by a lack of disease-specific findings on clinical, radiographic, and histopathologic exams. However, the outbreak remains in its early stages, and the underlying etiology is unknown. The median age of deceased patients was 53 years. The Centers for Disease Control and Prevention (CDC) has reported 37 related deaths in the United States as of October 29, 2019. Some data from the report bears emphasis: Patients had a median age of 19 years, 94% were hospitalized, with 62% in the ICU and 32% on mechanical ventilation. This preliminary report represents only a fraction of the 1888 cases that have been reported thus far, including patients from every state except Alaska. You worry that these symptoms may be related to the use of e-cigarettes but are unsure how to workup or manage this patient.Į-cigarette, or vaping, product use associated lung injury (EVALI) was first described in a case series of 53 patients from Illinois and Wisconsin. The patient reports that he doesn’t smoke cigarettes but has been using e-cigarettes daily for the past year to vape nicotine and tetrahydrocannabinol, the psychoactive component of marijuana. A 23-year-old man presents to the urgent care clinic with symptoms of progressing exertional dyspnea for the last 3 days.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |