title: [Nicolau syndrome after intramuscular injection].
abstract: Nicolau syndrome is a rare, potentially severe complication that may occur after any drug injection, particularly after intramuscular injection. It is characterized by the acute onset of cutaneous and soft-tissue aseptic necrosis. Here, we report the case of a 14-year-old boy diagnosed with Nicolau syndrome on the right lower limb, after a benzathine-penicillin intramuscular injection for suspected rheumatic fever. The short-term progression was marked by uncomplicated rhabdomyolysis and the constitution of homolateral testicular torsion. The cutaneous-muscular disorders evolved favorably under symptomatic treatment. We discuss this insufficiently known complication of intramuscular injection, which may motivate reduced use of this route of drug administration in children and strict adherence to the procedure. Furthermore, it is important to note that Nicolau syndrome may evolve to homolateral testicular torsion, as, to the best of our knowledge, is reported for the first time in this case.
authors.affiliation: Service de médecine infantile, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: B
authors.initials: B
authors.lastname: Bellot
authors.affiliation: Service de médecine infantile, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: C
authors.initials: C
authors.lastname: Bonnet
authors.affiliation: Service de médecine infantile, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: K
authors.initials: K
authors.lastname: Retornaz
authors.affiliation: Service d'imagerie médicale, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: M
authors.initials: M
authors.lastname: Panuel
authors.affiliation: Service de médecine infantile, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Garnier
authors.affiliation: Service de médecine infantile, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Dubus
authors.affiliation: Service de médecine infantile, hôpital Nord, chemin des Bourrely, 13915 Marseille cedex 20, France. Electronic address: anne-laure.jurquet@ap-hm.fr.
authors.forename: A-L
authors.initials: AL
authors.lastname: Jurquet
mesh_terms: D000293:Adolescent; D002081:Buttocks / Q000473:pathology; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects; D008297:Male; D065148:Nicolau Syndrome / Q000150:complications* / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D010401:Penicillin G Benzathine / Q000008:administration & dosage / Q000009:adverse effects*; D012206:Rhabdomyolysis / Q000209:etiology* / Q000473:pathology*; D013086:Spermatic Cord Torsion / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male
chemical_list: D010401:Penicillin G Benzathine