April 1983

Cellulitis From Extravasation of Calcium Gluconate Simulating Osteomyelitis

Author Affiliations

University of North Carolina School of Medicine and Moses H. Cone Memorial Hospital Greensboro, NC

Am J Dis Child. 1983;137(4):402-403. doi:10.1001/archpedi.1983.02140300080024

Extravasation of calcium gluconate in the neonate has been associated with a variety of soft-tissue injuries.1-5 We report a case of cellulitis secondary to extravasation of calcium gluconate in which the technetium Tc 99m bone scan suggested the diagnosis of osteomyelitis.

Report of a Case.—A male infant was born at term by uncomplicated vaginal delivery. Physical assessment was normal, except for jaundice and a palpable spleen tip. Exchange transfusion was done at 6 hours of age for blood type ABO incompatibility. The infant was discharged on the fifth day of life but was readmitted on the following day because of intermittent focal seizures. Results of physical examination were normal. The serum calcium level was 7.9 mg/dL, with a total serum protein level of 5.1g/dL. Intravenous (IV) phenobarbital sodium, followed by 3.5 mL of 10% calcium gluconate solution were given in the dorsum of one foot. Two hours later,