Nicolau syndrome following the injection of Pentavalent vaccine: A case report

Authors

  • Majid Sezavar Dukht Farooqi Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Rahele Rahimi Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Robabeh Mousavi Nejad Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Seyedeh Maryam Mousavi Community Health Research Center, School of Nursing and Midwifery, Islamic Azad University, Isfahan Unit (Khorasgan), Iran.
  • Toktam Etezadi Jam Department of Nursing, School of Nursing, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract:

Background: Nicolau syndrome is a rare condition that happens after intramuscular injection. All the intramuscular injections may have mild to moderate complications such as pain, focal abscess, nerve complication and anaphylactic reactions. Among these complications, wide necrosis of the skin like Nicolau syndrome happens very rarely. In this condition, Patients typically report acute, intense pain, immediately after drug injection and it is followed by an erythematous macular evolving after 24 hours into a livedoid violaceous patch with dendritic extensions. The study has been reported a case report of a 6-month-old infant who suffered from Nicolau syndrome after the injection of pentavalent vaccine. Methods: A 6-month-old girl infant without a history of any disease was referred to the emergency department with the signs of erythema, edema and purple like discoloration in the vaccine injection site at the left tight, after vaccination. One hour after admission, in the lower limb severe edema along with an extension of a dark red to purple discoloration happened on different parts of foot and after 5 days they turned necrotic. The infant suffered from Nicolau syndrome after the injection of the pentavalent vaccine. Conclusion: Although Nicolau syndrome is a very rare complication with no definitive treatment but can be prevented and not be aggravated by doing proper method of intramuscular injection and no application of cold compress (aspiration the needle for 5–10 seconds before injecting to make sure not to hit a blood vessel, the proper method of z-track, holding injection immediately if the patient complains excruciating pain on injection site, appropriate length of the needle to reach muscle, and different sites for multiple injections). However, due to lack of supporting evidence, needle aspiration is not recommended because no major vessel runs through the normal vaccination zone and that faster method is less painful. So, the vaccination must be done in right place with an appropriate length of the needle.

Upgrade to premium to download articles

Sign up to access the full text

Already have an account?login

similar resources

Nicolau syndrome: report of a case

Nicolausyndrome or embolia cutis medicamentosa is a rare complication of intramuscular injection of some drugs. This syndrome has been reported after injection of NSAIDS, corticosteroids and antibiotics.Here we report a 16-year-old boy who developed this syndrome after intramuscular injection of benzathine penicillin.

full text

Nicolau syndrome following intramuscular penicillin injection.

Nicolau Syndrome (NS) is a rare but severe localized adverse reaction at the site of intramuscular drug injection. The typical presentation is intense pain around the injection site soon after injection, followed by erythema, purplish network discolouration of the skin, haemorrhagic patch, and finally tissue necrosis. Here in, we report a 9 years old boy, the third Nicolau Syndrome (NS) reporte...

full text

Nicolau syndrome following intramuscular diclofenac administration: a case report.

Nicolau syndrome (livedoid dermatitis) is a rare adverse reaction of a still largely unidentified pathogenesis at the site of intramuscular drug injection. The typical presentation is pain around the injection site soon after injection, followed by erythema, livedoid patch, haemorrhagic patch, and finally necrosis of skin, subcutaneous fat, and muscle tissue. The phenomenon has been related to ...

full text

Nicolau Syndrome in Patient Following Diclofenac Administration: A Case Report

Nicolau syndrome is a rare adverse reaction to a variety of intra-muscular drug preparations. The typical presentation is pain around the injection site soon after injection, followed by erythema, livedoid patch, hemorrhagic patch, and finally, necrosis of skin, subcutaneous fat, and muscle tissue. The phenomenon has been related to the administration of a variety of drugs, including non-steroi...

full text

Case Report: Nicolau syndrome due to etofenamate injection

Nicolau syndrome, also known as embolia cutis medicomentosa, is a rare complication characterized by tissue necrosis that occurs after injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery and cytotoxic effects of the drug. Severe pain in the immediate postinjection period and purplish discoloration of the skin with ...

full text

Nicolau Syndrome following Intramatricial Triamcinolone Injection for Nail Lichen Planus

Nicolau syndrome (Embolia cutis medicamentosa) is a rare complication following parenteral administration of a drug. It has been reported in association with intramuscular, subcutaneous, intravenous and intra-articular injections. However, Nicolau syndrome following intramatricial injection has not been described to the best of our knowledge. We report the case of an 18-year-old male who develo...

full text

My Resources

Save resource for easier access later

Save to my library Already added to my library

{@ msg_add @}


Journal title

volume 79  issue 7

pages  563- 567

publication date 2021-10

By following a journal you will be notified via email when a new issue of this journal is published.

Keywords

Hosted on Doprax cloud platform doprax.com

copyright © 2015-2023