treatment in scelerema

[selvanr4]

When the neonate presents with scelerema the prognosis is guarded.Do you treat with antibiotics, FFP ,IV gamma or with exchange transfusion?
We recently admitted 2 noenates with septic shock who presented with scelerema witin 36 hrs after birth.
Bactec c&s grew organism and hence antibiotics were started along with ionotroes. Both of them went downhill and while the were on ventilator, Double volume exchange was done. It helped both the babies.
Please share your views
dr.selvan
Erode. India

[manuel perez valdez]

In my oppinion, i prescribe antibiotics, prothrombin time and parcial tromboplastyn time correction, also Na and K deficiencys, albuminum transfusion depends off the plasma levels. Usually, i don't recommend ETT because those babies has a vascular and perfusion stroke, and i try to shared this paper...

STATE-OF-THE-ART
Sclerema neonatorum: a review of nomenclature, clinical
presentation, histological features, differential diagnoses
and management.
Journal of Perinatology (2008) 28, 453–460

[drakjaleel]

Sclerema in a neonate is a frustating end results if we pick up early as it first appears on the cheek decends down with good appropriate iv antibiotics will improve where overwheming sepsis with sclerema may get some benificial effort fron ET again an risky invasive procedure.Are these babies are premies??

[selvanr4]

please read this which quotes good response to exchange trasfusion;
http://www.ncbi.nlm.nih.gov/pubmed/18368059

[takshafat]

is there any role of steroids in sclerema

[selvanr4]

we use short course of steroids (dexamethasone) for 3 days at the start of sclerema management. It has not helped in all cases. I do not have a authentic reference.