Thermal epiglottitis in adults: A new complication of illicit drug use

Abstract

Four cases of acute epiglottitis due to thermal injury were identified in a larger study of 407 cases of epiglottitis in Rhode Island from 1975 through 1992. All occurred in young adults (aged 22–33 yr) and were caused by the inhalation of heated objects when smoking illicit drugs (a tip of a marijuana cigarette in 1 case and metal pieces from crack cocaine pipes in 3 cases). Symptoms, signs, and X-ray and laryngoscopic findings were similar to infectious epiglottitis. All recovered with observation and intravenous antibiotics; none required intubation. Emergency physicians should be aware of this etiology when managing young adults who present with acute epiglottitis.