Nicolau Syndrome: A Rare Complication following Intramuscular Injection

A 5-year-old boy presented to the emergency department with a 2-day history of fever, sore throat, abdominal pain, and vomiting. He was prescribed amoxicillin for suspected streptococcal pharyngitis, however, this was not tolerated due to severe vomiting. He was given an intramuscular (IM) injection of benzathine penicillin G in the right deltoid and subsequently developed arm pain and erythema (Figure  1). Due to worsening gangrenous changes and concern for compartment syndrome with loss of peripheral pulses, the patient underwent fasciotomy (Figure 2; available at www.jpeds.com).

Source: The Journal of Pediatrics - May 2, 2019 Category: Pediatrics Authors: Elizabeth Quincer, Preeti Jaggi Tags: Rediscovering the Physical Exam Source Type: research