CTICasesLegionella pneumonia simulating EVALI
Imaging findings
CT scan of a 41-year-old male with acute respiratory failure shows severe symmetric bilateral consolidation. Although vaping history raised concern for EVALI, workup revealed positive urine Legionella antigen and positive tracheal aspirate PCR for Legionella pneumophila, which cleared following targeted antibiotic therapy.
Key takeaways
Severe infectious pneumonias, such as Legionella, can closely mimic vaping-associated lung injury (EVALI) both clinically and radiographically. The CDC guidelines require excluding active infection before confirming a diagnosis of EVALI.
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