Young patient with vaping history presenting with shortness of breath and progressive acute lung injury. Presentation radiograph (Day 1) has very subtle findings, which progressed to more pronounced diffuse acute lung injury over 3 days.

The supporting history of vaping in a young patient helps to make this diagnosis. On Day 2, the lower lobe predominant process supports vaping-induced lung injury. On Day 3, the Chest CT highlights features described with vaping including groundglass opacities and subpleural sparing.