A Rare Complication of Phenytoin Infusion in Newborn: Purple Glove Syndrome

A 2190 g male neonate was born at 34 weeks of gestation by emergency cesarean section (fetal bradycardia).  He admitted to the intensive care unit due to prematurity and perinatal asphyxia. He had tonic-clonic convulsions in the upper extremities on the second day of life refractory to ongoing phenobarbital, midazolam treatments.  Phenytoin of 40 mg was intended to infuse over 30 minutes, through a peripheral venous cannula on the right hand. The purple-blue discoloration of the right hand and arm was observed at the 15^th minute of infusion.  The right arm had become edematous in hours.