Extravasation of calcium gluconate concomitant with osteomyelitis in a neonate.

Extravasation of calcium gluconate is not an uncommon complication in neonatal units, which may result in skin and soft tissue inflammation, injury and even infection. We report an 11-day-old preterm infant who developed osteomyelitis at an infiltrated intravenous site through which calcium gluconate was infused. The patient was initially treated conservatively as a simple calcium-infiltrate. Clinical condition deteriorated until proper antibiotic treatment was given. We exclude other possible causes and assume that calcium-infiltrate had an important role in the pathogenesis. We conclude that osteomyelitis should be considered in a patient with calcium extravasation whose soft tissue inflammation does not improve as expected. Furthermore, using a diluted calcium solution and checking the insertion site frequently in order to identify extravasation earlier would prevent the complication.