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Published on: November 11, 2014
Extravasation of calcium gluconate concomitant with osteomyelitis in a neonate
Ming-Chou Chiang1, Yi-Hung Chou, Chao-Ran Wang
1Division of Neonatology, Chang Gung Children's Hospital, Linkou, Taoyuan, Taiwan.
Insights
Calcium gluconate extravasation can cause serious complications in newborns. This case report highlights osteomyelitis as a potential risk, emphasizing early detection and preventative measures in neonatal units.
Area of Science:
- Neonatal Medicine
- Pediatric Infectious Diseases
- Clinical Case Reports
Background:
- Extravasation of calcium gluconate is a known complication in neonatal intensive care units.
- It can lead to soft tissue inflammation, injury, and infection.
Observation:
- An 11-day-old preterm infant developed osteomyelitis at an intravenous infusion site.
- The site had previously experienced calcium gluconate extravasation.
Findings:
- Initial conservative treatment for simple calcium infiltrate failed.
- The infant's condition worsened until appropriate antibiotic therapy was initiated.
- Osteomyelitis was confirmed, with calcium infiltrate considered a significant factor in its development.
Implications:
- Osteomyelitis should be considered in neonatal cases of calcium extravasation with persistent soft tissue inflammation.
- Using diluted calcium solutions and frequent monitoring can prevent severe complications.
- Prompt diagnosis and treatment are crucial for managing neonatal extravasation injuries.
Abstract:
Extravasation of calcium gluconate is not an uncommon complication in neonatal units, which may result in skin and soft tissue inflammation, injury and even infection. We report an 11-day-old preterm infant who developed osteomyelitis at an infiltrated intravenous site through which calcium gluconate was infused. The patient was initially treated conservatively as a simple calcium-infiltrate. Clinical condition deteriorated until proper antibiotic treatment was given. We exclude other possible causes and assume that calcium-infiltrate had an important role in the pathogenesis. We conclude that osteomyelitis should be considered in a patient with calcium extravasation whose soft tissue inflammation does not improve as expected. Furthermore, using a diluted calcium solution and checking the insertion site frequently in order to identify extravasation earlier would prevent the complication.
