Unusual Suspect Causing Cavitary Pneumonia in a Vape Smoker

<i>Actinomyces</i> 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 <i>Actinomyces</i> 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 <i>Actinomyces odontolyticus</i>.