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CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2023; 15(02): 099-101
DOI: 10.1055/s-0043-1761214
Case Report

Tissue Damage Caused by Diclofenac Intramuscular Injection: The Nicolau Syndrome

Afzal Anees
1   Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
,
Yaqoob Hassan 
1   Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
,
Zainab Yusufali Motiwala
1   Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
,
Isna Rafat Khan
1   Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
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Abstract

Introduction Nicolau syndrome is an extremely rare complication following intramuscular administration of drugs leading to tissue damage and necrosis.

Case Report In this case, the patient received the injection from an untrained quack surgeon (Jarrah) due to an improper intramuscular injection technique. A 45-year-old female complained of pain and blackish discoloration of the skin over the left buttock after receiving an intramuscular diclofenac injection.[4] The patient was managed by administering intravenous antibiotics and analgesics, followed by surgical debridement. Flap reconstruction was done after granulation tissue formation.

Conclusion Healthcare should be sought from appropriately trained and licensed professionals. Patients should be well educated on this. Pain, erythema, and discoloration should be recognized as red flags of the Nicolau syndrome so that it can be addressed promptly to avoid complications.

Keywords

injection - diclofenac - Nicolau syndrome - intramuscular

Authors' Contribution

Authors contributed to preparation of the case report and approved its finally revised version.


Patient's Consent

The authors confirm that an informed consent was provided by the patient. All efforts were made for totally anonymous reporting.


Compliance with Ethical Principles

No prior ethical approval is required for single cases reports. Informed consent has been taken from the patient and can be sent to the editor.




Publication History

Article published online:
23 February 2023

© 2023. The Libyan Biotechnology Research Center. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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