Unusual Suspect Causing Cavitary Pneumonia in a Vape Smoker

Actinomyces species are facultative anaerobic bacteria that are part of the normal flora of the human oral cavity, gastrointestinal tract, and vaginal tract. These bacteria are known to cause actinomycosis, a rare chronic granulomatous infection that typically presents as a slowly progressive disease. Pulmonary actinomycosis, although rare, has long been recognized as a distinct form of pneumonia, typically affecting individuals with underlying risk factors such as poor oral hygiene, aspiration risk, pre-existing lung disease, or immunocompromising conditions. The recent surge in electronic cigarette (e-cigarette) use has prompted concerns regarding its potential role in predisposing individuals to pulmonary infections, including those caused by commensal oral flora such as Actinomyces species. Here, we present a case of a 48-year-old immunocompetent woman with no significant medical conditions or risk factors aside from a five-year history of vaping, who developed a cavitary pneumonia caused by Actinomyces odontolyticus.