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

TL;DR

This case report discusses the anesthetic challenges faced during burn surgery for a six-month-old with atypical toxic epidermal necrolysis.

Contribution

The paper presents a unique case of atypical TEN in an infant, emphasizing anesthetic strategies for such rare and complex conditions.

Findings

The patient exhibited full-thickness necrotic wounds without typical bullae or sloughing.

Anesthetic planning required careful perioperative assessment and airway management due to diagnostic uncertainty.

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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