Anticoagulant and vasodilator therapy for nicolau syndrome following intramuscular benzathine penicillin injection in a 4 year old boy

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Bozkaya T. A., Demirel G., ÖRMECİ T., Al S., Çakar E., TAŞTEKİN A., ...More

Archivos Argentinos de Pediatria, vol.114, no.3, 2016 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 114 Issue: 3
  • Publication Date: 2016
  • Doi Number: 10.5546/aap.2016.eng.e184
  • Journal Name: Archivos Argentinos de Pediatria
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Keywords: Nicolau syndrome, benzathine penicillin, enoxaparine, pentoxifylline
  • Istanbul Medipol University Affiliated: Yes


Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous injection of particular drugs leading to ischemic necrosis of the surrounding skin, soft tissue and muscular tissue. Benzathine penicilin one of the most widely used antibiotic for upper respiratory tract infections and has been rarely reported to cause NS. Here we describe a 4 year old boy with diagnosis of NS after the injection of benzathine penicillin who was successfuly treated with unfractionized heparin (enoxaparine) and pentoxifylline. The practitioners should pay attention for unnecessary use of benzathine penicillin to avoid from probable complications.