The use of cannabis as both a therapeutic agent and recreational drug is very common and its availability is increasing as a result of legalization
Among adolescents and older children, the manifestations of cannabis intoxication are numerous and include neurological changes such as somnolence, euphoria, psychosis, ataxia, tremor, nystagmus, mood alterations, attention alternations, excessive motor activity and muscle relaxation; and general signs, including tachycardia, blood pressure fluctuations, vomiting, conjunctival hyperemia and dry mouth. There have been only a few reports describing cannabis intoxication in infants and toddlers.
Herein we describe 3 infants who presented to the emergency department with an acute comatose state without additional pathologic signs and despite an absence of history of exposure, all were diagnosed with cannabis intoxication. Patients ages ranged from 8 to 14 months old. Diagnosis confirmation was obtained by rapid urine toxic screen for THC (delta-9-tetrahydrocannabinol). All patients were treated with supportive care.
The differential diagnosis of altered level of consciousness in children is diverse and includes brain lesions, trauma, infections, intoxications, metabolic abnormalities and many more states. The nonspecific symptomatology of cannabis intoxication in infants and the wide differential for unexplained acute onset encephalopathy may delay diagnosis and lead to inappropriate procedures and interventions such as antibiotic and antiviral treatments.
Conclusion: These cases should raise the awareness of pediatricians in the emergency room to the potential risk s of cannabis ingestion in young infants. A thorough anamnesis and toxic screen are warranted in all infants with unexplained decreased sensorium.
