Challenging Airway Secondary to Purpura Fulminans With Face and Neck Bullae in a Premature Infant: A Case Report
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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Rhashedah A Ekeoduru1, Matthew R Greives, Eric A Nesrsta
1From the Departments of Pediatric Anesthesiology and Pediatric Plastic Surgery, Children's Memorial Hermann Hospital, McGovern Medical School, Houston, Texas.
Abstract:
A former 25-week-old neonate presented at 34 weeks postconceptual age with necrotizing fasciitis and purpura fulminans because of Group B Streptococcus infection. He was septic and coagulopathic when he was intubated, and the endotracheal tube was secured with adhesives. When he subsequently developed large purpuric, bullous lesions on the face and neck, he presented to the operating room for excision and debridement of his facial lesions. No change was made in how the endotracheal tube was secured. Midprocedure, an unintentional extubation occurred. We describe how we subsequently secured the airway and make recommendations on how to avoid this problem in the future and for rescue preparation before the procedure.
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