Nitroglycerin patch use in digital ischemia secondary to sepsis: a case report

Area of Science:

• Neonatal Medicine
• Pediatric Infectious Diseases
• Vascular Surgery

Background:

• Sepsis in neonates, particularly preterm infants, presents significant challenges due to immature immune systems.
• Infants' limited inflammatory response can lead to rapid progression of infection, increasing risks of pneumonia and meningitis.
• Peripheral ischemic complications are a serious, though less common, manifestation of neonatal sepsis.

Observation:

• A 26-week preterm infant boy developed acute digital ischemia in his right index finger.
• The ischemia was progressing towards gangrene, indicating a severe manifestation of septicemia.
• The infant's immature inflammatory response likely contributed to the rapid progression of the septicemic complication.

Findings:

• Topical nitroglycerin patch application was utilized to manage the impending peripheral gangrene.
• This non-invasive treatment successfully alleviated the ischemic condition in the affected digit.
• No adverse effects were observed during the treatment period, highlighting the safety profile.

Implications:

• Topical nitroglycerin may be a viable therapeutic option for managing peripheral ischemic complications in neonatal sepsis.
• Early recognition and intervention are crucial for preventing severe outcomes like gangrene in septic infants.
• This case underscores the importance of considering diverse clinical presentations of sepsis in preterm neonates.