DOI: 10.36347/sjmcr.2017.v05i07.007

Pages: 436-437

Extravascular iatrogenic extravasation corresponds to the passage of a perfusion product and its tissue distribution at the injection site; its consequences depend on the nature of the product concerned, and the risk of progressive and disabling skin necrosis are major. We report the clinical case of a 45-year-old patient, followed for type 2 diabetes for 3 years and put on insulin, admitted initially for community-acquired pneumonia, for which she was hospitalized and put under amoxicillin protected by intravenous peripheral line in the right wrist. Four days later the evolution was marked by the onset of pain with tumefaction and severe edema at the site of the perfusion, drug extravasation was suspected which justified the immediate cessation of the perfusion, but the evolution was quickly marked by the appearance of extensive necrotic plate extending on the side face of the distal third of the right forearm and the right hand. We retained the diagnosis of skin necrosis secondary to extravasation of antibiotic therapy based on amoxicillin-clavulanic acid. Given the extension of necrosis, treatment consisted of amputation of the hand and puting the patient under antibiotics. The extravasation is to be considered as a serious complication of intravenous treatments and its management as a surgical emergency is absolute. Whatever the injected product, it is necessary to respect the recommended route of administration, and after extravasation of a product it is mandatory to control the injection site.