Related Experiment Video
Updated: Jan 9, 2026

Accelerated Type 1 Diabetes Induction in Mice by Adoptive Transfer of Diabetogenic CD4+ T Cells
Published on: May 6, 2013
Nicolau Syndrome following Benzathine Benzylpenicillin Injection in a Patient with Syphilis and Type 2 Diabetes: A
Yuyan Cheng1, Yiwen Mao1, Jingwen Wang1
1Department of Dermatology and Venereology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Introduction:
Nicolau syndrome (NS) is a rare complication following intramuscular (IM), intra-articular, or subcutaneous injections, marked by severe localized pain, skin discoloration, and tissue necrosis. Treatments focus on halting causative agents, pain control, and preventing secondary infections. Here we describe a case of NS due to the use of penicillin G benzathine for syphilis.
Case Presentation:
A 39-year-old male presented with a painful rash on his left buttock 3 min after IM injection of penicillin G benzathine for the treatment of syphilis. The patient, with a history of type 2 diabetes, experienced significant complications including rhabdomyolysis and liver dysfunction. After the treatment of corticosteroids, anticoagulation, fluid resuscitation, and alkalinizing the urine, the patient recovered well.
Conclusion:
NS may result from accidental arterial injection (causing vascular occlusion) or hypersensitivity reactions to medications. We reported the clinical course of a case of NS and highlight the need for proper injection technique, early intervention, and multidisciplinary care to manage NS and its complications.
Related Concept Videos
Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Diabetes Mellitus: Type 2 and Gestational
Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Diabetes: Symptoms, Diagnosis, and Complications
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Endocarditis II: Clinical Features of Infective Endocarditis