{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:22:39Z","timestamp":1784193759125,"version":"3.55.0"},"reference-count":19,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,16]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>A 33-year-old man without significant medical history presented to the emergency department with a 6-month history of fatigue and 30 pounds of unintentional weight loss, with a recent cough and fever over the past week. He recalled two similar illnesses during college that did not require medical care. He denied tobacco use but reported inhaling marijuana 1\u20132 times daily over the past year with a vaping device. Physical exam was notable for a temperature of 100.0\u00b0F and an elevated blood pressure at 161\/77\u2009mm Hg. He was diaphoretic with clear breath sounds bilaterally. Chest imaging revealed diffuse ground glass opacities with subpleural sparing and mildly enlarged hilar lymph nodes. Bronchoscopy with transbronchial lung biopsies and needle aspirate of lymph nodes revealed organising pneumonia, and subsequent cultures grew <jats:italic>Actinomyces odontolyticus<\/jats:italic>. He was treated with amoxicillin and corticosteroids with subsequent resolution on repeat chest imaging.<\/jats:p>","DOI":"10.1136\/bcr-2020-240973","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T13:22:03Z","timestamp":1617283323000},"page":"e240973","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Pulmonary actinomycosis and marijuana vaping"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9373-8802","authenticated-orcid":false,"given":"Michelle","family":"Massey","sequence":"first","affiliation":[{"name":"School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Barney","sequence":"additional","affiliation":[{"name":"Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"2025082803052007000_14.4.e240973.1","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1056\/NEJMc1913069","article-title":"Pathology of vaping associated lung injury","volume":"381","author":"Butt","year":"2019","journal-title":"N Engl J Med"},{"key":"2025082803052007000_14.4.e240973.2","unstructured":"Paul Stark MD . High resolution computed tomography of the lungs. Waltham, MA: UpToDate, 2020."},{"key":"2025082803052007000_14.4.e240973.3","unstructured":"Helen Hollingsworth MD . E-cigarette or vaping product use associated lung injury (EVALI). Waltham, MA: UpToDate, 2020."},{"key":"2025082803052007000_14.4.e240973.4","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.15585\/mmwr.mm6845e2","article-title":"Evaluation of Bronchoalveolar Lavage Fluid from Patients in an Outbreak of E-cigarette, or Vaping, Product Use-Associated Lung Injury - 10 States, August-October 2019","volume":"68","author":"Blount","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025082803052007000_14.4.e240973.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1916433"},{"key":"2025082803052007000_14.4.e240973.6","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aaz0108"},{"key":"2025082803052007000_14.4.e240973.7","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph16020294","article-title":"E-cigarettes increase Candida albicans growth and modulate its interaction with gingival epithelial cells","volume":"16","author":"Alanazi","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"2025082803052007000_14.4.e240973.8","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1111\/odi.13564","article-title":"Electronic cigarette vapor increases Streptococcus mutans growth, adhesion, biofilm formation, and expression of the biofilm-associated genes","volume":"27","author":"Rouabhia","year":"2021","journal-title":"Oral Dis"},{"key":"2025082803052007000_14.4.e240973.9","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00089103"},{"key":"2025082803052007000_14.4.e240973.10","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-13-216"},{"key":"2025082803052007000_14.4.e240973.11","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00100-14"},{"key":"2025082803052007000_14.4.e240973.12","doi-asserted-by":"publisher","DOI":"10.1002\/path.1700750225"},{"key":"2025082803052007000_14.4.e240973.13","first-page":"100950","article-title":"Drastically progressive lung cavity lesion caused by Actinomyces odontolyticus in a patient undergoing chemoradiotherapy: A case report and literature review","volume":"28","author":"Matsumoto","year":"2019","journal-title":"Respir Med Case Rep"},{"key":"2025082803052007000_14.4.e240973.14","doi-asserted-by":"crossref","DOI":"10.1002\/rcr2.493","article-title":"A pulmonary infection by Actinomyces odontolyticus and Veillonella atypica in an immunocompetent patient with dental caries","volume":"7","author":"Crisafulli","year":"2019","journal-title":"Respirol Case Rep"},{"key":"2025082803052007000_14.4.e240973.15","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000016911","article-title":"Lung abscess by Actinomyces odontolyticus and Parvimonas micra co-infection presenting as acute respiratory failure: a case report","volume":"98","author":"Yun","year":"2019","journal-title":"Medicine"},{"key":"2025082803052007000_14.4.e240973.16","doi-asserted-by":"crossref","first-page":"793","DOI":"10.21037\/atm.2019.12.38","article-title":"Pulmonary lesions associated with sputum culture-positive actinomycetes: report of one case","volume":"7","author":"Wang","year":"2019","journal-title":"Ann Transl Med"},{"key":"2025082803052007000_14.4.e240973.17","doi-asserted-by":"crossref","first-page":"211","DOI":"10.26444\/aaem\/75652","article-title":"Pulmonary actinomycosis - the great imitator","volume":"25","author":"Grzywa-Celi\u0144ska","year":"2017","journal-title":"Ann Agric Environ Med"},{"key":"2025082803052007000_14.4.e240973.18","doi-asserted-by":"publisher","DOI":"10.1159\/000321247"},{"key":"2025082803052007000_14.4.e240973.19","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.040394-0"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240973","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:05:29Z","timestamp":1756375529000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240973"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,1]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/bcr-2020-240973"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240973","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}