scholarly journals Post-injection embolia cutis medicamentosa – Nicolau Syndrome: case report and literature review

2016 ◽  
Vol 15 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Carlos Alberto Araujo Chagas ◽  
Tulio Fabiano de Oliveira Leite ◽  
Lucas Alves Sarmento Pires
Keyword(s):  
Healthcare Professionals ◽  
Subcutaneous Tissue ◽  
Vascular Complication ◽  
Benzathine Penicillin ◽  
Intense Pain ◽  
Large Ulcer ◽  
Intramuscular Injections ◽  
Nicolau Syndrome ◽  
Left Buttock ◽  
Embolia Cutis Medicamentosa

Abstract We report on the case of a 40-year-old male who was admitted to the clinic with a large ulcer on his left buttock, 3 days after an intramuscular benzathine penicillin injection. The patient was diagnosed with Nicolau syndrome, a rare vascular complication in which a lesion develops after intramuscular injection. Symptoms are intense pain at the injection site, erythema, and livedoid dermatitis, which leads to necrosis of skin, subcutaneous tissue and muscle tissue. It was described by Nicolau after intramuscular injections of bismuth salt for syphillis therapy. Nicolau syndrome is rare, but its symptoms are devastating and healthcare professionals must be aware of this clinical entity, since intramuscular injections are common procedures for administration of drugs.

NICOLAU SYNDROME IN A CHILD FOLLOWING IV CLINDAMYCIN INJECTION-DECODING THE PURPLE PUZZLER

2021 ◽  
pp. 51-52
Author(s):  
Anusree Krishna Mandal ◽  
Jadab Kumar Jana ◽  
Soumya Gayen
Keyword(s):  
Literature Review ◽  
Injection Site ◽  
Local Anesthetics ◽  
Skin Necrosis ◽  
Rare Complication ◽  
Left Forearm ◽  
Intense Pain ◽  
Intramuscular Injections ◽  
Nicolau Syndrome ◽  
Muscle Necrosis

Nicolau syndrome is a rare complication of intramuscular injections caused by various drugs that present with intense pain and induration at the injection site. It is characterized by local aseptic skin necrosis and rarely, muscle necrosis on the injection site. It has rarely been reported to occur after intramuscular injections of anti-inammatory drugs, corticosteroids, local anesthetics, penicillin and interferon. Our literature review revealed no cases of Nicolau syndrome following intravenous (IV) clindamycin injections. Herein, we report a case of Nicolau syndrome that occurred after IV clindamycin injection in the left forearm of a 1.5-year child, that was notable because of the uniqueness of the syndrome coupled with the fact that it has not previously been reported after intravenous clindamycin injection.

scholarly journals Embolia Cutis Medicamentosa - A Case Report

2021 ◽  
Vol 10 (12) ◽  
pp. 910-911
Author(s):  
Shiliveri Sadhan Siddardha ◽  
Kolluru Karthik Raja ◽  
Amrutha Garikapati ◽  
Sameera Dronamraju ◽  
Sunil Kumar
Keyword(s):  
Clinical Course ◽  
Subcutaneous Tissue ◽  
Rare Complication ◽  
Arterial Lumen ◽  
Nicolau Syndrome ◽  
Bismuth Salts ◽  
Embolia Cutis Medicamentosa ◽  
Muscle Necrosis ◽  
Skin Discoloration ◽  
Vessel Thrombosis

Embolia cutis medicamentosa is a rare complication of intramuscular injury that leads to varying degrees of necrosis of the skin and subcutaneous tissue. In 1924, embolia cutis medicamentosa or Nicolau syndrome (NS) was first portrayed after an intragluteal injection of bismuth salts was given for the treatment of syphilis but it has now been documented with several drugs. (Murthy et al., 2007)1. According to one hypothesis, embolia cutis medicamentosa occurs when an intramuscular drug is accidentally injected into the arterial lumen or wall, leading to vessel thrombosis, subcutaneous tissue and muscle necrosis (Senel et al., 2010)2. Necrosis develops after hyperemia, skin discoloration usually associated with severe pain and wide inflammatory livedoid dermatitis and haemorrhagic patch at the injection site (Hamilton et al., 2008)3. Severe cases may take an immediate clinical course and anticipate to death.

NICOLAU SYNDROME DUE TO INTRAMUSCULAR DICLOFENAC SODIUM INJECTION

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Harris I Shaafie ◽  
Soumya Agarwal ◽  
Swosti Mohanty ◽  
Chandni Jain
Keyword(s):  
Standard Treatment ◽  
Rare Complication ◽  
Diclofenac Sodium ◽  
Tissue Necrosis ◽  
Cytotoxic Effects ◽  
Direct Damage ◽  
Nicolau Syndrome ◽  
Syndrome Diagnosis ◽  
Embolia Cutis Medicamentosa ◽  
Pigmentary Pattern

Nicolau syndrome (NS) is a rare complication characterized by tissue necrosis that occurs after parenteral injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery, acute vasospasm and cytotoxic effects of the drug. Severe pain in the immediate post injection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease. Herein, we present a rare case of NS due to Diclofenac Sodium (Voltaren®) injection in an 80-year-old female suffering from Lower Respiratory Tract Infection (LRTI) who was managed conservatively. Keywords: Nicolau Syndrome, Embolia cutis medicamentosa, Voltaren, Diclofenac sodium

Nicolau Syndrome (Embolia Cutis Medicamentosa)

2018 ◽  
Vol 40 (3) ◽  
pp. 212-215 ◽  
Author(s):  
Dominic Tabor ◽  
Chandra G. Bertram ◽  
Andrew J. K. Williams ◽  
Marie E. Mathers ◽  
Asok Biswas
Keyword(s):  
Nicolau Syndrome ◽  
Embolia Cutis Medicamentosa

scholarly journals Giant idiopathic pyoderma gangrenosum at an unusual site with highly elevated c-ANCA levels: A rare association

2021 ◽  
pp. 58-61
Author(s):  
Lovleen Kaur ◽  
Mohita Mahajan ◽  
Parul Chojer ◽  
Bharat Bhushan Mahajan ◽  
Suresh Kumar Malhotral
Keyword(s):  
Pyoderma Gangrenosum ◽  
Rapid Progression ◽  
Intense Pain ◽  
Unusual Site ◽  
Early Management ◽  
Systemic Involvement ◽  
Patient Reported ◽  
Rate Of Progression ◽  
Left Buttock ◽  
Systemic Abnormality

Pyoderma gangrenosum (PG) is a rare neutrophilic disorder with an incidence rate of 3–10 cases per million per year, characterized by classically painful and aseptic ulcers, which may be associated with underlying systemic diseases. The pathergy reaction is seen in one-fourth of patients with PG. Accurate and timely diagnosis is crucial, as PG is known for its rapid progression. The management of PG is challenging and depends on its severity and rate of progression. An underlying systemic involvement should be sought even in spite of no symptoms. Herein, we report a case of giant pyoderma gangrenosum involving almost the entire left buttock with exceptionally raised c-ANCA levels, but no underlying systemic abnormality. The patient reported intense pain, rapid progression of the ulcers, an inability to perform daily activities, was significantly morbid and pathergy-positive. Aggressive and early management is required in cases such as this. A dramatic response was achieved with a combination of cyclosporine, dapsone, and methylprednisolone pulses.

scholarly journals Nicolau syndrome after intramuscular benzathine penicillin injection

2021 ◽  
Vol 64 ◽  
pp. 101597
Author(s):  
Yapo Guy serge Kouamé ◽  
Jean Baptiste Yaokreh ◽  
Moufidath Sounkeré ◽  
Samba Tembely ◽  
Idalia Taguela Ajoumissi ◽  
...  
Keyword(s):  
Benzathine Penicillin ◽  
Nicolau Syndrome

scholarly journals Nicolau syndrome following intramuscular benzathine penicillin injection: a case report

2020 ◽  
Vol 37 ◽  
Author(s):  
Walaza Phiri ◽  
Maen Shulammite Musonda ◽  
Kebby Kyakilika ◽  
Michelo Haluuma Miyoba ◽  
Malan Malumani
Keyword(s):  
Case Report ◽  
Benzathine Penicillin ◽  
Nicolau Syndrome

Childhood Desmoplastic Fibroblastoma (Collagenous Fibroma) with a 12-Year Follow-up

1999 ◽  
Vol 2 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Gaetano Magro ◽  
Carmelo Venti
Keyword(s):  
Subcutaneous Tissue ◽  
Collagenous Fibroma ◽  
Desmoplastic Fibroblastoma ◽  
First Case ◽  
Left Buttock

We report the first case of a childhood desmoplastic fibroblastoma (collagenous fibroma). The tumor was located in subcutaneous tissue of the left buttock in a 5-year-old boy. No recurrence has been observed after 12 years, the longest follow-up available.

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