Vaping-induced acute epiglottitis: a case report
Abstract Background E-cigarette use, or vaping, is an alternative nicotine delivery system that is becoming increasingly prevalent in adolescents and young adults. There is currently a lack of comprehensive research on the adverse effects of vaping on the upper airway. Acute epiglottitis is a potent...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | International Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12245-023-00532-x |
| _version_ | 1797454007628726272 |
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| author | Amir Khorrami Mohammad Ali Khorrami Heitham Gheriani |
| author_facet | Amir Khorrami Mohammad Ali Khorrami Heitham Gheriani |
| author_sort | Amir Khorrami |
| collection | DOAJ |
| description | Abstract Background E-cigarette use, or vaping, is an alternative nicotine delivery system that is becoming increasingly prevalent in adolescents and young adults. There is currently a lack of comprehensive research on the adverse effects of vaping on the upper airway. Acute epiglottitis is a potentially life-threatening condition that can lead to airway obstruction. It is commonly caused by bacterial infections such as streptococci, staphylococcus, and Moraxella. Adult patients with acute epiglottitis mainly present with odynophagia, dysphagia, and respiratory difficulties. The diagnosis of epiglottitis is made by direct laryngoscopy, and the mainstay of treatment is antibiotics. Bozella et al. (2020) reported a case of subacute non-infectious epiglottitis associated with e-cigarette use in a pediatric patient (Pediatrics 145(3), 2020). Here we present a case of acute epiglottitis in a healthy young adult after vaping, with a negative infectious workup. To our knowledge, there has been no such reported case of epiglottitis associated with e-cigarette use in an adult patient. Case description A previously healthy 29-year-old male with daily e-cigarette use presented to the emergency department with a severe sore throat, dysphagia, mild hoarseness, and shortness of breath, especially when lying supine. A lateral neck soft tissue radiograph revealed a thickened epiglottis with a thumb sign. Direct bedside laryngoscopy showed a swollen epiglottis, partially obstructing the supraglottic region confirming the diagnosis of acute epiglottitis. Throat and nasal swabs were negative for streptococcus and COVID-19 infection, respectively. The patient’s condition improved significantly after receiving intravenous Dexamethasone and antibiotics for 2 days. Repeat laryngoscopy showed the resolution of epiglottis swelling, and subjective symptoms had resolved entirely 2 weeks following the start of the treatment. Conclusions Although bacterial infections usually cause acute epiglottitis, this case presents the second report of this condition associated with vaping with negative microbiological investigations. Therefore, we recommend that physicians consider non-infectious causes such as vaping in their differential diagnosis for patients with acute and subacute epiglottitis. More research is warranted on the utility of antibiotics in treating vaping-induced epiglottitis. |
| first_indexed | 2024-03-09T15:31:02Z |
| format | Article |
| id | doaj.art-3e6494d201514603a0d86340029b8280 |
| institution | Directory Open Access Journal |
| issn | 1865-1380 |
| language | English |
| last_indexed | 2024-03-09T15:31:02Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-3e6494d201514603a0d86340029b82802023-11-26T12:15:05ZengBMCInternational Journal of Emergency Medicine1865-13802023-09-011611410.1186/s12245-023-00532-xVaping-induced acute epiglottitis: a case reportAmir Khorrami0Mohammad Ali Khorrami1Heitham Gheriani2Faculty of Medicine, University of British ColumbiaFaculty of Medicine, University of British ColumbiaDepartment of Surgery Division of Otolaryngology, University of British ColumbiaAbstract Background E-cigarette use, or vaping, is an alternative nicotine delivery system that is becoming increasingly prevalent in adolescents and young adults. There is currently a lack of comprehensive research on the adverse effects of vaping on the upper airway. Acute epiglottitis is a potentially life-threatening condition that can lead to airway obstruction. It is commonly caused by bacterial infections such as streptococci, staphylococcus, and Moraxella. Adult patients with acute epiglottitis mainly present with odynophagia, dysphagia, and respiratory difficulties. The diagnosis of epiglottitis is made by direct laryngoscopy, and the mainstay of treatment is antibiotics. Bozella et al. (2020) reported a case of subacute non-infectious epiglottitis associated with e-cigarette use in a pediatric patient (Pediatrics 145(3), 2020). Here we present a case of acute epiglottitis in a healthy young adult after vaping, with a negative infectious workup. To our knowledge, there has been no such reported case of epiglottitis associated with e-cigarette use in an adult patient. Case description A previously healthy 29-year-old male with daily e-cigarette use presented to the emergency department with a severe sore throat, dysphagia, mild hoarseness, and shortness of breath, especially when lying supine. A lateral neck soft tissue radiograph revealed a thickened epiglottis with a thumb sign. Direct bedside laryngoscopy showed a swollen epiglottis, partially obstructing the supraglottic region confirming the diagnosis of acute epiglottitis. Throat and nasal swabs were negative for streptococcus and COVID-19 infection, respectively. The patient’s condition improved significantly after receiving intravenous Dexamethasone and antibiotics for 2 days. Repeat laryngoscopy showed the resolution of epiglottis swelling, and subjective symptoms had resolved entirely 2 weeks following the start of the treatment. Conclusions Although bacterial infections usually cause acute epiglottitis, this case presents the second report of this condition associated with vaping with negative microbiological investigations. Therefore, we recommend that physicians consider non-infectious causes such as vaping in their differential diagnosis for patients with acute and subacute epiglottitis. More research is warranted on the utility of antibiotics in treating vaping-induced epiglottitis.https://doi.org/10.1186/s12245-023-00532-xEpiglottitisElectronic cigarettesVapingInflammatory epiglottitisInfectious epiglottitisThumb sign |
| spellingShingle | Amir Khorrami Mohammad Ali Khorrami Heitham Gheriani Vaping-induced acute epiglottitis: a case report International Journal of Emergency Medicine Epiglottitis Electronic cigarettes Vaping Inflammatory epiglottitis Infectious epiglottitis Thumb sign |
| title | Vaping-induced acute epiglottitis: a case report |
| title_full | Vaping-induced acute epiglottitis: a case report |
| title_fullStr | Vaping-induced acute epiglottitis: a case report |
| title_full_unstemmed | Vaping-induced acute epiglottitis: a case report |
| title_short | Vaping-induced acute epiglottitis: a case report |
| title_sort | vaping induced acute epiglottitis a case report |
| topic | Epiglottitis Electronic cigarettes Vaping Inflammatory epiglottitis Infectious epiglottitis Thumb sign |
| url | https://doi.org/10.1186/s12245-023-00532-x |
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