Marijuana use has been increasing across the United States due to its 
legalization as both a medicinal and recreational product. A small number of 
case reports have described a pathological entity called vanishing lung syndrome 
(VLS), which is a rare bullous lung disease usually caused by tobacco smoking. 
Recent case reports have implicated marijuana in the development of VLS. We 
present a case of a 47-year-old man, who presented to our hospital with 
shortness of breath, fevers and a productive cough. On physical exam, he was 
tachypneic with audible stridor and absent right sided breath sounds. 
Laryngoscopy showed a retropharyngeal abscess, and chest radiography showed a 
possible right pneumothorax. Chest computed tomography (CT) showed bilateral 
bullous emphysematous lung disease with a giant bulla occupying most of his 
right lung field. He was placed on mechanical ventilation and treated with broad 
spectrum antibiotics in the intensive care unit, where he developed acute 
respiratory distress syndrome (ARDS). He continued to decline, and developed 
disseminated intravascular coagulation, after which he succumbed to his disease.