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Necrosis of infantile haemangioma with propranolol therapy
  1. Jamie Alexander Grech1,
  2. Thomas Calleja2,
  3. Paul Soler1,
  4. David Pace1
  1. 1Department of Child and Adolescent Health, Mater Dei Hospital, Msida, Malta
  2. 2Malta Foundation School, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Jamie Alexander Grech, Department of Child and Adolescent Health, Mater Dei Hospital, Msida MSD2090, Malta; jamie.a.grech{at}

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A 4-month-old girl born at 30+6 weeks’ gestation was started on propranolol 1.5 mg/kg/day in three divided doses for a rapidly growing infantile haemangioma (IH) on the scalp. Two weeks later the haemangioma became painful with wet necrosis (figure 1) and an offensive serosanguinous discharge, from which Escherichia coli, Klebsiella pneumoniae and anaerobes were cultured. She was systemically well and afebrile. Propranolol was stopped and the infection …

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