# Multiple Subcutaneous Calcifications in a Neonate after Intravenous Calcium Gluconate: A Case Report

## TL;DR

A neonate developed multiple subcutaneous calcifications after receiving intravenous calcium gluconate, which resolved with conservative management.

## Contribution

This case highlights subcutaneous calcifications as a rare complication of intravenous calcium gluconate in neonates.

## Key findings

- Calcium gluconate extravasation can cause tender subcutaneous nodules in neonates.
- Radiographs may not show calcifications immediately after extravasation.
- Conservative management led to complete resolution of lesions within 12 weeks.

## Abstract

Extravasation of calcium gluconate can lead to erythema, tenderness, induration, edema and sometimes iatrogenic calcinosis cutis. Subcutaneous calcification may be mistaken for cellulitis, abscess, calcified hematoma, or osteomyelitis, resulting in unnecessary antibiotic therapy or surgical intervention. A 36+5 weeks male baby with birth weight 2500 grams, presented on 4th day of life with fever and neonatal hyperbilirubinemia. He developed symptomatic hypocalcemia and was treated with multiple doses of intravenous calcium gluconate infusion. At one week follow up he presented with multiple tender hard nodules distributed over previous cannulation sites. He was managed conservatively. Paracetamol was given for pain management. There was complete resolution of lesions by 12 weeks. Radiographs in soft tissue calcification after extravasation of calcium gluconate are initially negative, take one to three weeks to appear and usually months to resolve.