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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

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[Nicolau syndrome].

Edwin A Rodríguez Arias¹, María Fernanda Sola¹, Lorea De Arza Pochylak¹

¹Servicio de Clínica Médica, Hospital Nacional Profesor Alejandro Posadas, Buenos Aires, Argentina.

|February 12, 2023

Summary

Nicolau syndrome is a rare adverse drug reaction. This case highlights its occurrence after benzathine penicillin injection, treated successfully with enoxaparin and cilostazol.

Keywords:

Nicolau syndrome adverse effect drug skin embolism livedoid dermatitis penicillin

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Area of Science:

Pharmacology
Dermatology
Pathology

Background:

Nicolau syndrome is a rare but severe complication following parenteral drug administration.
It typically manifests as localized pain, edema, erythema, and potential necrosis.

Observation:

A case report of a 31-year-old male presenting with Nicolau syndrome.
The syndrome developed subsequent to intramuscular benzathine penicillin injection.

Findings:

Clinical diagnosis of Nicolau syndrome was confirmed by biopsy.
Treatment with enoxaparin and cilostazol led to patient improvement.

Implications:

This case underscores the importance of recognizing Nicolau syndrome as a potential adverse event.
Early diagnosis and appropriate anticoagulation/vasodilator therapy may improve outcomes for patients with Nicolau syndrome.