Anesthetic Management of Atypical Toxic Epidermal Necrolysis in a Six-Month-Old Patient Undergoing Burn Surgery: A Case Report.

Cureus  – May 01, 2025

Source: PubMed

Summary

A rare skin condition called toxic epidermal necrolysis (TEN) presented uniquely in a 6-month-old infant, requiring innovative medical care. Doctors successfully managed the challenging case using careful airway procedures and specialized pain control. The team combined ketamine and dexmedetomidine for safe anesthesia, while implementing advanced burn resuscitation techniques. This approach led to successful surgery and recovery.

Abstract

Toxic epidermal necrolysis (TEN) is a rare, life-threatening skin condition that involves widespread skin detachment and mucous membrane damage. We present a case of a six-month-old male with atypical TEN transferred from an outside hospital in Mexico to our facility. The patient had widespread full-thickness necrotic wounds but no bullae or sloughing. Since the diagnosis was unclear at the time, it posed a significant challenge to make an appropriate anesthetic plan given the need for prolonged intubation after extensive burn debridement and grafting surgery. This case report highlights the importance of perioperative assessment, induction strategy, airway management, resuscitation, and pain control in an atypical TEN patient.

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