Shocking X-rays show how a US 19-year-old who vapes e-cigarettes has been left with oil-filled lungs and fighting for his life.
Anthony Mayo from Erie, Pennsylvania, became seriously ill last week as he struggled to breathe, looked pale and felt sick, his parents said.
Doctors later found that his lungs were severely congested with the solidified vape oil, which they compared to hardened grease from cooking bacon.
The teen's father, Keith Mayo, told Metro US that doctors warned him that he has lungs of a 60-year-old, two-pack-a-day, smoker and that his organs would most likely be scarred for life.
The concerned father revealed that his son had been vaping for approximately two years and had tried flavoured oils such as blue raspberry, Swedish fish, cotton candy, cinnamon toast crunch, among others.
He also vaped THC on occasion, which is the psychoactive ingredient in marijuana.
Vaping works by heating liquid in a tank and turning it into steam to be inhaled - but some oil droplets may be leftover as the liquid cools back down in the airways.
Anthony Mayo arrived at Millcreek Community Hospital on September 8 after he developed a hefty cough.
At the time, doctors believed he had bronchitis and gave him antibiotics. However, two days later he returned to the emergency room when developed other symptoms.
Doctors feared it was walking pneumonia, which inflames the lungs and may fill them with fluid, so they prescribed him a stronger antibiotic and steroid.
After another two days of his health getting worse, he visited his family doctor who bumped up his medication along with a "puffer," which is a medicine that is inhaled to quickly treat coughing or shortness of breath.
But his condition only worsened, leading him to return to the emergency room Monday (local time) where tests revealed his oxygen levels were at 36 per cent.
Anything below 90 per cent is considered potentially dangerous, according to the Mayo Clinic.
The teen is now recovering in hospital where he is on oxygen support. Doctors are also pumping heated oxygen with moisture into Anthony's lungs to help liquefy some of the solidified oil.
This will cause Anthony to cough up some of the liquid - which is brown, dark green and occasionally blood-tinged, his father Keith said.
Speaking to Metro US about the ordeal, Keith said: "[My son's] whole spin on it was it was cool and not that bad for you. I was just as guilty. I went along with it. I never got into it, but I didn't also prevent it either.
"He is going to have some scarring. Whether it's profound, we don't know yet. It's a wait and see type of thing. He's young, he's 19, so he can recover from this."
Keith added: "As the doctor says, anytime you put moisture into your lungs it's not good. It's solidified. It's caking everything inside of his lungs."
Keith also shared a Facebook post about how vaping affects everyone differently.
"His GF [girlfriend] has vaped the same stuff for four years. Was she affected - NOPE! If it was poisoned or tainted, she would be affected also," he wrote.
"My goal is to get this info out there. Because of this, I know that six people have quit and gotten rid of their vaping equipment."
Anthony's mother, Tanya, who has set up a fundraising page, shared the scan on Facebook.
"A warning for those in denial. This is what vaping looks like when your otherwise healthy 19-year-old is admitted into the ICU," she wrote.
"Left lung [is] about 80 per cent congested and right is about 50 per cent, oxygen level was 37.
"According to the doctor this is showing areas that have essentially solidified like bacon grease.
"The pulmonary doctor said he had seen dead people with a higher oxygen level. A full recovery is uncertain... Only time will tell."
Anthony's story comes as health officials have confirmed an eighth vaping-related death in the US.
A Missouri man in his forties had normal lung function until he started using the devices in May, health officials said.
He developed mild respiratory symptoms that slowly worsened and he was taken to hospital on August 22.
The number of people sickened by vaping has risen to 500, according to figures by the Centers for Disease Control and Prevention (CDC).
No specific brand or flavour of e-cigarette has been linked to any of the illnesses, which health officials are still investigating.
Peter Openshaw, professor of experimental medicine at Imperial College London, commented on the stark rise in mystery vaping-related illnesses.
"There is no doubt that inhaling a range of substances – from diesel particulates to tobacco smoke - risks harming the lung.
"It is well known that oils such as paraffin can cause problems because they can be inhaled without triggering protective cough reflexes, for example by fire-eaters and those taking liquid paraffin by mouth.
"It seems possible that these case clusters are related to inhalation of oil or oil and water mixtures that cause immune activation and trigger both local inflammation in the lung (pneumonitis) and, in some cases, systemic inflammation.
"Exactly why and how remains to be determined."