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Dergiler / Düzce Tıp Fakültesi Dergisi / 2026 / Volume: 28 Issue: 2

Intramuscular Ceftriaxone Injection-Induced Nicolau Syndrome: A Case Report

Selen Taner Akbay(HATAY MUSTAFA KEMAL UNIVERSITY)0000-0003-0368-9096
Sayfa
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Yayın Tarihi
2026-08-21
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Conservative wound care, anti-inflammatory therapy and empiric antibiotics led to complete healing with residual hypopigmented atrophic scarring at six months, highlighting the importance of early recognition and proper injection technique.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Nicolau syndrome, also known as embolia cutis medicamentosa, is a rare ischemic complication of parenteral drug administration.
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Temel Bulgular & Veri:We report a 53-year-old man who developed severe pain, swelling, erythema and violaceous necrotic discoloration involving the left gluteal region and extending to the left femoral area after four intramuscular ceftriaxone injections administered by a non-healthcare professional.
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Sonuç & Katkı:Conservative wound care, anti-inflammatory therapy and empiric antibiotics led to complete healing with residual hypopigmented atrophic scarring at six months, highlighting the importance of early recognition and proper injection technique.
🔬Tür:Case Report
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Nicolau syndrome · ceftriaxone · skin necrosis

Abstract

Nicolau syndrome, also known as embolia cutis medicamentosa, is a rare ischemic complication of parenteral drug administration. Ceftriaxone-associated cases are exceptionally uncommon. We report a 53-year-old man who developed severe pain, swelling, erythema and violaceous necrotic discoloration involving the left gluteal region and extending to the left femoral area after four intramuscular ceftriaxone injections administered by a non-healthcare professional. Examination revealed a tender, warm, livedoid-necrotic plaque measuring approximately 20 cm. Histopathology demonstrated epidermal and dermal necrosis, fibrinoid necrosis of dermal vessels and a neutrophil-rich panniculitis-like infiltrate. Doppler ultrasonography did not show arterial or venous occlusion and the clinical course was not compatible with necrotizing fasciitis. Nicolau syndrome was diagnosed. Conservative wound care, anti-inflammatory therapy and empiric antibiotics led to complete healing with residual hypopigmented atrophic scarring at six months, highlighting the importance of early recognition and proper injection technique.

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Bu Makaleye Atıf Yap

Akbay, S. T. (2026). Intramuscular Ceftriaxone Injection-Induced Nicolau Syndrome: A Case Report. Düzce Tıp Fakültesi Dergisi, Volume: 28 Issue: 2. https://doi.org/10.18678/dtfd.1884077

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Kaynakça (14)

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