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April 1983, Vol 137, No. 4 >
Article | April 1983

Cellulitis From Extravasation of Calcium Gluconate Simulating Osteomyelitis FREE

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

REFERENCES

1 +
Berger PE, Heidelberger KP, Poznanski A:  Extravasation of calcium gluconate as a cause of soft tissue calcification in infancy . AJR 1974;;121: 109-117.
2 +
Lee FA, Gwinn JL:  Roentgen patterns of extravasation of calcium gluconate in the tissues of the neonate . J Pediatr 1975;;86:598-601.
3 +
Ramamurthy RS, Harris V, Pildes RS:  Subcutaneous calcium deposition in the neonate associated with intravenous administration of calcium gluconate . Pediatrics 1975;;55:802-806.
4 +
Balsam D, Goldfarb CR, Stringer B, et al:  Bone scintigraphy for neonatal osteomyelitis: Simulation by extravasation of intravenous calcium . Radiology 1980;;135:185-186.
5 +
Propst-Proctor SL, Jones RB, Nagel DA:  Iatrogenic soft-tissue calcification in an extremity . J Bone Joint Surg Am 1982;;64:449-450.
6 +
Weissberg ED, Smith AL, Smith DH:  Clinical features of neonatal osteomyelitis . Pediatrics 1974;;53:505-510.
7 +
Fox L, Sprunt K:  Neonatal osteomyelitis . Pediatrics 1978;;62:535-542.
8 +
Edwards MS, Baker CJ, Wagner ML, et al:  An etiologic shift in infantile osteomyelitis: The emergency of group B Streptococcus . J Pediatr 1978;;93:578-583.
9 +
Treves S, Khettry J, Broker FH, et al:  Osteomyelitis: Early scintigraphic detection in children . Pediatrics 1976;;57:173-186.
10 +
Treves S:  Skeletal scintigraphy in the diagnosis of acute osteomyelitis . Hosp Pract , (August) 1979;, pp 66-73.
11 +
Lisbona R, Rosenthall L:  Observations on the sequential use of 99mTc-phosphate complex and 67Ga imaging in osteomyelitis, cellulitis, and septic arthritis . Radiology 1977;;123:123-129.

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References

1 +
Berger PE, Heidelberger KP, Poznanski A:  Extravasation of calcium gluconate as a cause of soft tissue calcification in infancy . AJR 1974;;121: 109-117.
2 +
Lee FA, Gwinn JL:  Roentgen patterns of extravasation of calcium gluconate in the tissues of the neonate . J Pediatr 1975;;86:598-601.
3 +
Ramamurthy RS, Harris V, Pildes RS:  Subcutaneous calcium deposition in the neonate associated with intravenous administration of calcium gluconate . Pediatrics 1975;;55:802-806.
4 +
Balsam D, Goldfarb CR, Stringer B, et al:  Bone scintigraphy for neonatal osteomyelitis: Simulation by extravasation of intravenous calcium . Radiology 1980;;135:185-186.
5 +
Propst-Proctor SL, Jones RB, Nagel DA:  Iatrogenic soft-tissue calcification in an extremity . J Bone Joint Surg Am 1982;;64:449-450.
6 +
Weissberg ED, Smith AL, Smith DH:  Clinical features of neonatal osteomyelitis . Pediatrics 1974;;53:505-510.
7 +
Fox L, Sprunt K:  Neonatal osteomyelitis . Pediatrics 1978;;62:535-542.
8 +
Edwards MS, Baker CJ, Wagner ML, et al:  An etiologic shift in infantile osteomyelitis: The emergency of group B Streptococcus . J Pediatr 1978;;93:578-583.
9 +
Treves S, Khettry J, Broker FH, et al:  Osteomyelitis: Early scintigraphic detection in children . Pediatrics 1976;;57:173-186.
10 +
Treves S:  Skeletal scintigraphy in the diagnosis of acute osteomyelitis . Hosp Pract , (August) 1979;, pp 66-73.
11 +
Lisbona R, Rosenthall L:  Observations on the sequential use of 99mTc-phosphate complex and 67Ga imaging in osteomyelitis, cellulitis, and septic arthritis . Radiology 1977;;123:123-129.

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