Zargarbashi Ramin, Panjavi Behnam, Keshavarz-Fathi Mahsa
Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Cancer Immunology Project, Universal Scientific Education and Research Network, Tehran, Iran.
Int J Low Extrem Wounds. 2023 Mar;22(1):113-116. doi: 10.1177/1534734620948768. Epub 2020 Aug 17.
Nicolau syndrome (NS) is a rare cutaneous drug reaction in response to injections administered via any route. Based on the available studies in the medical literature, NS presents as skin and subcutaneous fat necrosis, and typically, it does not cause severe complications such as acute limb ischemia or death. In this study, we report the case of a 6-year-old boy who received an intramuscular injection of benzathine penicillin G for the treatment of bacterial pharyngitis, and subsequently developed a severe case of NS, which eventually led to below-knee amputation of the right lower limb. Although a few approaches have been suggested for the management of NS, they might not be effective under certain circumstances. Early detection, close monitoring, and consistent interventions, such as surgical fasciotomy and debridement procedures, might be necessary in severe cases of NS.
尼科劳综合征（NS）是一种罕见的因任何途径注射给药引起的皮肤药物反应。根据医学文献中的现有研究，NS表现为皮肤和皮下脂肪坏死，通常不会引发诸如急性肢体缺血或死亡等严重并发症。在本研究中，我们报告了一名6岁男孩的病例，该男孩因治疗细菌性咽炎接受了苄星青霉素G肌肉注射，随后发生了严重的NS病例，最终导致右下肢膝下截肢。尽管已提出了一些治疗NS的方法，但在某些情况下可能无效。对于严重的NS病例，早期检测、密切监测以及持续干预（如手术筋膜切开术和清创术）可能是必要的。
