An Exceptional Cause of Acute Limb Ischemia: Nicolau Syndrome-Single-Center Experience with 4 Cases
| Autor: | Meli Josephine, Abel Teyang, Fokou Marcus, Eyenga Victor Claude |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Injections Intramuscular Amputation Surgical 030218 nuclear medicine & medical imaging Fasciotomy Gangrene Upper Extremity 03 medical and health sciences Young Adult 0302 clinical medicine Ischemia medicine Humans Wound Healing business.industry Nicolau Syndrome General Medicine Syndrome Middle Aged medicine.disease Thrombosis Surgery Treatment Outcome Amputation Debridement Lower Extremity Acute Disease Etiology Female Cardiology and Cardiovascular Medicine Intramuscular injection Complication business |
| Zdroj: | Annals of vascular surgery. 58 |
| ISSN: | 1615-5947 |
| Popis: | Background Causes of acute limb ischemia are classically mainly emboli and thrombosis. Nicolau syndrome is a very rare complication of intramuscular injection presumed to be related to the inadvertent intravascular injection. It was first reported after intramuscular injection of bismuth salt, but it can occur as a complication of various other drugs. Acute limb ischemia is one of its severe outcomes but is rarely encountered and reported. Methods Patients admitted with the final diagnosis of Nicolau syndrome in our institution in 3 years (2016 2017 and 2018) are reviewed in terms of etiology, clinical presentation, management, and outcome. Results We present here 4 cases of Nicolau syndrome that lead to acute limb ischemia and with the same outcome: limb or fingers loss; there were 2 upper extremities for 2 women secondary to diclofenac and dexamethasone intramuscular administration and 2 lower extremities for 2 men in relation with Benzathine Penicillin intramuscular administration. The medical and surgical management that we attempted did not prevent this severe outcome. Conclusions Nicolau syndrome should be considered when looking for rare etiologies of acute limb ischemias. |
| Databáze: | OpenAIRE |
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