Levene Rachel J, Pollak-Christian Elza, Wolfram Sigrid
Department of Pediatrics, SUNY Downstate Medical Center, Brooklyn, New York.
Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York.
J Emerg Med. 2019 Jan;56(1):94-96. doi: 10.1016/j.jemermed.2018.09.040. Epub 2018 Oct 16.
Cannabis is one of the most abused drugs worldwide, with more than 20 million users in the United States (US). As access to cannabis products increases with expanding US legislation and decriminalization of marijuana, emergency physicians must be adept in recognizing unintentional cannabis toxicity in young children, which can range from altered mental status to encephalopathy and coma.
We report the case of a 13-month-old female presenting with self-limiting altered mental status and lethargy, with a subsequent diagnosis of tetrahydrocannabinol exposure on confirmatory urine gas chromatography-mass spectrometry. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Considering caretakers rarely report possible cannabis exposure, history-taking must review caretakers' medicinal and recreational drug exposures to prevent inadvertently missing the diagnosis. In the young child with altered mental status, prompt urine screening for cannabinoid detection can prevent further invasive and costly diagnostic investigations, such as brain imaging and lumbar puncture.
大麻是全球滥用最为广泛的毒品之一，在美国有超过2000万使用者。随着美国立法的放宽以及大麻合法化，大麻产品的可及性增加，急诊医生必须熟练识别幼儿意外大麻中毒情况，中毒症状从精神状态改变到脑病及昏迷不等。
我们报告了一名13个月大的女性病例，该患儿出现自限性精神状态改变和嗜睡，随后通过尿液气相色谱-质谱联用仪确诊为接触四氢大麻酚。急诊医生为何应了解此情况？鉴于看护人很少报告可能的大麻接触情况，病史采集必须审查看护人的药用和消遣性药物接触情况，以防止无意中漏诊。对于精神状态改变的幼儿，及时进行尿液大麻素筛查可避免进一步进行侵入性且昂贵的诊断检查，如脑部成像和腰椎穿刺。
