• Dr. Siddaruda M. Biradar

Nicolau syndrome (NS) is a rare complication that can occur after intramuscular or subcutaneous injections. There is no tool/test exists for making a confirmative diagnosis of NS; it is purely based on the clinical features and their correlation with previous case history. With its rarity, correct diagnosis may be delayed, and furthermore tissue necrosis may be developed by inappropriate treatment. A 22-year-old female came to outpatient department with a complaint of lesion over right buttock. She gave the history of intense pain and bluish discolouration in her right buttock after intramuscular injection of diclofenac. She experienced severe dull pain immediately after the injection. Physical examination revealed an abnormal finding in the right buttock area with erythematous reticular rash and USG of the gluteal region revealed large area of diffuse subcutaneous hemorrhage in right gluteal region. Though the conservative treatment was given, patient condition got worsened and seen with tissue necrosis. As case came to the notice of clinical pharmacist, the current symptoms where compared with the literature survey of similar cases and provisionally assumed to be Nicolau syndrome. Then it was brought to the notice of medical team where it was discussed in detail & finally diagnosed with NS. Then necrotized tissue was removed with surgical debridement & advised with daily dressings. NS awareness among the health care professionals could help to diagnose the disease at its early stage and may restrict further progression of the disease.

: Intramuscular injection, Erythematous reticular rash-surgical debridement, Nicolau syndrome

"Nicolau Syndrome Secondary to Intra-Muscular (IM) Injection", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.10, Issue 6, page no.j25-j30, June-2023, Available :http://www.jetir.org/papers/JETIR2306905.pdf

"Nicolau Syndrome Secondary to Intra-Muscular (IM) Injection", International Journal of Emerging Technologies and Innovative Research (www.jetir.org | UGC and issn Approved), ISSN:2349-5162, Vol.10, Issue 6, page no. ppj25-j30, June-2023, Available at : http://www.jetir.org/papers/JETIR2306905.pdf