Intramuscular Ceftriaxone Injection-Induced Nicolau Syndrome: A Case Report
DUZCE MEDICAL JOURNAL, cilt.28, sa.2, ss.242-245, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 28 Sayı: 2
- Basım Tarihi: 2026
- Doi Numarası: 10.18678/dtfd.1884077
- Dergi Adı: DUZCE MEDICAL JOURNAL
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO)
- Sayfa Sayıları: ss.242-245
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Hatay Mustafa Kemal Üniversitesi Adresli: Evet
Özet
Nicolau syndrome, also known as embolia cutis medicamentosa, is a rare ischemic complication of parenteral drug administration. Ceftriaxone-associated cases are exceptionally uncommon. We report a 53-year-old man who developed severe pain, swelling, erythema and violaceous necrotic discoloration involving the left gluteal region and extending to the left femoral area after four intramuscular ceftriaxone injections administered by a non-healthcare professional. Examination revealed a tender, warm, livedoid-necrotic plaque measuring approximately 20 cm. Histopathology demonstrated epidermal and dermal necrosis, fibrinoid necrosis of dermal vessels and a neutrophil-rich panniculitis-like infiltrate. Doppler ultrasonography did not show arterial or venous occlusion and the clinical course was not compatible with necrotizing fasciitis. Nicolau syndrome was diagnosed. Conservative wound care, anti-inflammatory therapy and empiric antibiotics led to complete healing with residual hypopigmented atrophic scarring at six months, highlighting the importance of early recognition and proper injection technique.