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A 19-year-old man with a one-year history of vaping with multiple emergency room visits for acute gastroenteritis like symptoms was noted to have asymptomatic hypoxia with a PaO2 of 65 mmHg. Computed tomography revealed bilateral nodular lung infiltrates. History was negative for travel, allergies, or animal exposure. An infectious work-up was negative for bacterial, viral, or fungal infections, including bronchoalveolar lavage sample cultures. He did not show improvement upon initial empiric antibacterial and antifungal treatment. His h