researchers say teen’s thermal epiglottitis was cannabis-induced
epiglottitis is a potentially life-threatening condition that occurs when the small cartilage “lid” covering the windpipe swells
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image for representation. teen presented with a muffled voice, fever, drooling, difficulty swallowing, painful swallowing, rapid breathing and elevated white blood cell count. /
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a case report involving a 17-year-old with what investigators believe is cannabis-induced thermal epiglottitis makes clear that completing a thorough patient history, physical examination and drug screening is criticially important.
mayo clinic explains that epiglottitis is a potentially life-threatening condition that occurs when the small cartilage “lid” covering the windpipe swells, thereby blocking air flow into the lungs. among the situations that can lead to the swelling are infections and being burned by something hot, like hot liquids.
“clinicians must consider thermal injury of the epiglottitis due to substance use, specifically marijuana in vaccinated adolescent patients presenting with positive substance use history, progressive dysphagia, odynophagia and drooling with a muffled voice,” notes the study abstract published this week in the american journal of emergency medicine.
upon arriving at a hospital emergency department, the previously healthy, vaccinated teen presented with a muffled voice, fever, drooling, difficulty swallowing, painful swallowing, rapid breathing and leukocytosis, often defined as an elevated white blood cell count.
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testing showed the teen had signifcant swelling of the epiglottitis, the larynx and throat had significant redness, swelling and secretions and his urine was positive for benzodiazepine, opiates and cannabinoids.
based on those findings, plus his negative bacterial cultures, the teen was diagnosed with thermal-induced epiglottitis secondary to cannabinoid use.
“the clinical and radiographic findings are similar in epiglottitis due to infectious and non-infectious etiologies,” study authors write. as such, beyond completing a patient history, physical exam and drug screening, “prompt management with intubation should occur to protect and maintain airway integrity,” they add.
while many causes of thermal epiglottitis have been described in the pediatric and young adult population — including a teenage girl who developed the condition from e-cigarettes — authors in the latest study called the teen’s case “unusual.”
in 2010, a study noted “the literature documents many other potential causes of uvulitis, including smoke and chemical irritation.”
but past studies linking epiglottitis and cannabis seem related to physical injury. a study released in 1997 identified four cases of acute epiglottitis among adults aged 22 to 33 that was “caused by the inhalation of heated objects when smoking illicit drugs.” however, in one case the injury was the result of a tip of a joint and the other three related to metal pieces from crack cocaine pipes.
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