Amputation of phalanges as an adverse effect of benzathine penicillin injection

Authors

  • Alexandre Sacchetti Bezerra Hospital Israelita Albert Einstein, Cirurgia Vascular - São Paulo - SP - Brasil.
  • Thais Dante Correia Rocha Faculdade de Medicina do ABC, Cirurgia Vascular - Santo André - SP - Brasil.
  • Xu Xue Quing Faculdade de Medicina do ABC, Cirurgia Vascular - Santo André - SP - Brasil.
  • Daniela dos Santos Ferreira Faculdade de Medicina do ABC, Pediatria - Santo André - SP - Brasil.
  • João Antonio Correa Faculdade de Medicina do ABC, Cirurgia Vascular - Santo André - SP - Brasil.
  • Domenico Monetta Neto Santa Casa de Misericórdia de São Paulo, Pediatria - São Paulo - SP - Brasil.

DOI:

https://doi.org/10.5935/2764-734X.e20240844

Keywords:

Nicolau Syndrome, Penicillin G Benzathine, Amputees, Fasciotomy, Compartment Syndromes, Case Report

Abstract

Nicolau syndrome is a rare adverse effect of a few types of intramuscular medications. We report a case of a 13-month-old child treated at the emergency room who had been medicated with benzathine penicillin for pharyngitis less than 24 hours before. The child developed critical lower limb ischemia homolateral to the gluteal region where the drug was administered, and although fasciotomy aiming to mitigate the compartment syndrome was performed at an early stage, the child developed mummification and spontaneous amputation of the phalanges. Nicolau syndrome is a complication of intramuscular antibiotic administration, and owing to its high morbidity rate, should be diagnosed and treated early.

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Published

2024-10-10

How to Cite

Bezerra, A. S., Rocha, T. D. C., Quing, X. X., Ferreira, D. dos S., Correa, J. A., & Monetta Neto, D. (2024). Amputation of phalanges as an adverse effect of benzathine penicillin injection. Infections in Evidence, 3, e20240844. https://doi.org/10.5935/2764-734X.e20240844

Issue

Vol. 3 (2024)

Section

Case Reports

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