Fatal E-cigarette or Vaping Product Use-associated Lung Injury Secondary to Streptococcus Constellatus Empyema

Empyema caused by Streptococcus constellatus in e-cigarette or vaping product use-associated lung injury (EVALI) can result in fatal outcomes. Empyema as a presentation of EVALI is rarely reported. S. constellatus is a known causative pathogen in empyema, typically associated with the elderly and immunocompromised states. We report the case of a 13-year-old male with a history of active e-cigarette use who presented to our center with right lung empyema, complicated by a suspected bronchopleural fistula. Despite chest drainage, antibiotic therapy, inotropic support, and mechanical ventilation, the patient ultimately succumbed to his illness. This case highlights a rarely reported severe complication of EVALI. Clinicians should be vigilant about obtaining a history of e-cigarette use in patients presenting with unexplained empyema.