Stomal sepsis and fatal haemorrhage following tracheostomy

A case of stomal sepsis and fatal haemorrhage following an emergency tracheostomy in a 28-year-old woman is presented. It is proposed that major haemorrhage can occur in the absence of a large vessel lesion as a result of local sepsis and inflammation. Infection in this setting can be predicted to be polymicrobial in origin and attention is therefore drawn to the need for early prophylactic antimicrobial therapy as well as the need for meticulous care of the stomal site.