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

Toxic epidermal necrolysis (TEN) is a rare, life-threatening skin condition causing widespread skin detachment and mucous membrane damage. A six-month-old male with atypical TEN was transferred from a hospital in Mexico to a US facility, presenting with widespread full-thickness necrotic wounds but no bullae or sloughing. The unclear diagnosis made anesthetic planning challenging due to the need for prolonged intubation after extensive burn debridement and grafting. This case report emphasizes perioperative assessment, induction strategy, airway management, resuscitation, and pain control for atypical TEN patients.

Study at a glance

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.