An 18-year-old man went to the ED with shortness of breath, cough, and chest pain that has been going on for more than a week. He had been to urgent care 4 days earlier and had a clear chest x-ray, but felt he was getting worse. He had developed abdominal pain, nausea, and fever. He reported that he had been losing weight recently but wasn’t sure why because he hadn’t changed his diet or exercise. During the exam, the doctor noticed he was tachycardic and had low oxygen saturation on room air. He admitted to occasional marijuana use and said he had recently started vaping in an effort to quit cigarette smoking. He was happy that vaping had really eliminated his dependence on cigarettes. A CT scan performed the same day shows ground glass opacities in his lungs.
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