Diclofenac-induced Isolated Myonecrosis and the Nicolau Syndrome
Authors: B. H. Ch. Stricker, B. J. van Kasteren
Journal: Annals of Internal Medicine (1992)

Letters15 December 1992Diclofenac-induced Isolated Myonecrosis and the Nicolau SyndromeB. H. Ch. Stricker, MB, PhD, B. J. van Kasteren, MD, PhDB. H. Ch. Stricker, MB, PhD, B. J. van Kasteren, MD, PhDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-12-1058_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: The Nicolau syndrome is a rare adverse reaction at the site of intramuscular drug injection resulting from acute ischemia. Within hours, patients develop severe pain and a localized erythematous rash followed by a pale marble-like discoloration and necrosis of the skin (1), sometimes accompanied by gangrene (2) and muscle necrosis.A 35-year-old male sports teacher complaining of acute neck pain was treated with 75 mg of diclofenac intramuscularly in the proximal anterolateral part of the left upper leg. After 2 days, severe pain developed at the site of injection; it gradually decreased over the following 4 months....References1. Nicolau S. Dermatite livédoide et gangréneuse de la fesse consécutive aux injections intramusculaires dans la syphilis. A propos d'un cas embolie artérielle bismuthique. Ann Mal Vén. 1925;20:321-39. Google Scholar2. TalbertHaslamHaller JRJ. Gangrene of the foot following intramuscular injection in the lateral thigh: a case report with recommendations for prevention. J Pediatr. 1967;70:110-21. CrossrefMedlineGoogle Scholar3. Müller-Vahl H. Aseptische Gewebsnekrose: eine schwerwiegende Komplikation nach intramuskulärer Injektion. Dtsch Med Wochenschr. 1984;109:786-92. CrossrefMedlineGoogle Scholar4. Tweedie D. Unusual reaction to diclofenac. Anaesthesia. 1989;44:932. CrossrefMedlineGoogle Scholar5. AliMathias MI. Continued problems with diclofenac injections. Anaesthesia. 1991;46:1089. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: B. H. Ch. Stricker, MB, PhD; B. J. van Kasteren, MD, PhD PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNicolau Syndrome, Masquerader of Postinjection Sciatic Nerve Injury: Case Report and Review of LiteratureNicolau syndrome caused by non‐steroidal anti‐inflammatory drugs: Systematic literature reviewRectal Indomethacin Versus Rectal Diclofenac Sodium for Reducing Pain Associated with Diagnostic Office HysteroscopyAseptic myonecrosis following intramuscular benzathine penicllin G injection: a novel syndromeCoincidence of Nicolau Syndrome and Rhabdomyolysis: Report of a Forensic Autopsy Case and Review of the LiteratureDiclofenacEnvironmentally Oriented Models and Methods for the Evaluation of Drug × Drug Interaction EffectsTransarterial Degradation of Hyaluronic Acid Filler by HyaluronidaseComplications of Injectable Fillers, Part 2: Vascular ComplicationsCommentaries on 'Diclofenac for acute pain in children'NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)A case of Nicolau syndrome treated with hyperbaric oxygenDiclofenac readily penetrates the cerebrospinal fluid in childrenNicolau syndrome aggravated by cold application after i.m. diclofenacÚlcera necrótica en cadera derechaDiclofenacNicolau syndrome caused by piroxicamA Prospective, Randomised Clinical Trial Comparing Oral Diclofenac Potassium and Intramuscular Diclofenac Sodium in Acute Pain ReliefNicolau syndrome following diclofenac administrationEmbolia cutis medicamentosa en un lactante por inmunización con DTPThe use of Injectable Nonsteroidal Anti-Inflammatory Drugs in Local Accident & Emergency PracticeNecrotizing Soft Tissue Infections Reported with Nonsteroidal Antiinflammatory DrugsDiclofenac-lnduced RhabdomyolysisStreptococcal myositis and tissue necrosis with intramuscular administration of diclofenacTissue Necrosis and Necrotizing Fasciitis After Intramuscular Administration of DiclofenacAnti-inflammatory analgesics and drugs used in rheumatoid arthritis and gout 15 December 1992Volume 117, Issue 12Page: 1058-1058KeywordsAdverse reactionsIschemiaMusclesMyalgiaNecrosisRashesSports ePublished: 1 December 2008 Issue Published: 15 December 1992 PDF downloadLoading ...