ABSTRACT
Nicolau syndrome (NS) is a rare complication of an intramuscular injection characterized by severe pain, skin discoloration, and varying levels of tissue necrosis. The case outcomes vary from atrophic ulcers and severe pain to sepsis and limb amputation. We describe a case of a seven-year-old boy with diagnosis of NS after intramuscular benzathine penicillin injection to the ventrolateral aspect of the left thigh. Characteristic violaceous discoloration of skin and immediate injection site pain identified it as a case of NS. The case was complicated by rapid progression of compartment syndrome of the lower limb, proceeding to acute renal failure and death. Associated compartment syndrome can be postulated as a poor prognostic factor for NS.
Subject(s)
Child , Compartment Syndromes/etiology , Drug Eruptions/complications , Fatal Outcome , Humans , Injections, Intramuscular/adverse effects , Acute Kidney Injury/etiology , Male , Pain/chemically induced , Penicillin G Benzathine/administration & dosage , Skin Diseases, Vascular/chemically induced , Skin Pigmentation/drug effects , Syndrome , ThighABSTRACT
Interferon-B (IFN-beta) é usado no tratamento de esclerose múltipla (EM). Descrevemos o caso de uma mulher com EM que apresentou fenômeno de Raynaud grave, livedo reticular e necrose digital duas semanas após tratamento com IFN-beta. Os sintomas melhoraram após suspensão do IFN-beta e início de anticoagulação associada a ciclofosfamida e corticóide. Fenômeno de Raynaud é um efeito colateral provável da terapia com IFN-beta para EM.