Case report: Nicolau syndrome in a pediatric patient

Abstract

Nicolau syndrome or embolism cutis medicamenta or livedoid dermatitis, is a rare syndrome in pediatrics that presents as a complication of an intramuscular injection with multiple degrees of tissue damage, including skin and deep tissue necrosis.
We report the case of a 2-year-old male patient, with no pathological history, who attended the pediatric emergency department of the "Mario Catarino Rivas" Hospital (HMCR) in San Pedro Sula, Cortes, with a history of presenting a necrotic lesion in the lower extremity. and left buttock, painful on palpation, which appeared after the administration of a compound medication intramuscularly. Physical examination revealed an extensive necrotic plaque that was painful on palpation and on movement of the limb, with preserved peripheral pulses and no distal coldness. Through a multidisciplinary approach, surgical cleaning, antibiotic coverage, antithrombotic management, and grafting were provided, with favorable evolution, for which we emphasize that timely multidisciplinary identification and management is essential.