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Vincenzo G Menditto, Federico Mei, Laura Postacchini, Lucia Manfredi, Silvia Tedesco, Giovanni Pomponio, Armando Gabrielli, Aldo Salvi
Riassunto. Background. La storia naturale e gli outcomes dei pazienti con embolia polmonare (EP) che si presentano con una sintomatologia non tipica (EP atipica) rimangono ancora poco chiari e studiati. Lo scopo di questo studio è quello di confrontare le caratteristiche cliniche e la prognosi dei pazienti con embolia polmonare a presentazione atipica e tipica. Metodi. Abbiamo analizzato retrospettivamente i dati dei pazienti ricoverati consecutivamente con diagnosi di embolia polmonare dal Pronto Soccorso in Medicina Interna dividendoli in due gruppi: pazienti con EP tipica e con EP atipica...
February 2019: Recenti Progressi in Medicina
Bhaskara P Shelley, Prasanth Prasad, Malla M Manjunath, Shrijeet Chakraborti
A case of Nicolau syndrome (NS) in a 36-year-old adult taking an unusual and devastating hyperacute irreversible paraplegia after an intramuscular injection of benzathine penicillin as a part of routine chemoprophylaxis of her rheumatic heart disease is reported. Although this syndrome is a considerably rare, iatrogenic and underappreciated dermatologic entity, we reiterate in this report, its extracutaneous systemic potential for a catastrophic neurovascular phenomenon and morbidity as well as its possible preventive measures...
January 2019: Annals of Indian Academy of Neurology
Polychronis Gatos-Gatopoulos, Stephanos Kostantoudakis, Ioannis G Panayiotides, George D Dimitriadis, Konstantinos Triantafyllou
Terlipressin is a synthetic long-acting analog of vasopressin widely used to control variceal bleeding by lowering portal venous pressure. We report an unusual adverse reaction to terlipressin in a 78-year-old patient with esophageal variceal bleeding who developed skin necrosis soon after treatment initiation. Skin biopsy revealed embolia cutis medicamentosa.
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Chander Grover, Geetali Kharghoria, Deepashree Daulatabad, Sambit N Bhattacharya
Nicolau syndrome (Embolia cutis medicamentosa) is a rare complication following parenteral administration of a drug. It has been reported in association with intramuscular, subcutaneous, intravenous and intra-articular injections. However, Nicolau syndrome following intramatricial injection has not been described to the best of our knowledge. We report the case of an 18-year-old male who developed this complication following 7(th) session of intramatricial injection. The patient was started on broad spectrum antibiotic coverage, vasodilator therapy, analgesics, and daily dressing...
September 2017: Indian Dermatology Online Journal
Emin Ozlu, Aysegul Baykan, Ragıp Ertas, Yılmaz Ulas, Kemal Ozyurt, Atıl Avcı, Halit Baykan
Nicolau syndrome, also known as embolia cutis medicomentosa, is a rare complication characterized by tissue necrosis that occurs after injection of drugs. The exact pathogenesis is uncertain, but there are several hypotheses, including direct damage to the end artery and cytotoxic effects of the drug. Severe pain in the immediate postinjection period and purplish discoloration of the skin with reticulate pigmentary pattern is characteristic of this syndrome. Diagnosis is mainly clinical and there is no standard treatment for the disease...
2017: F1000Research
Dominic Tabor, Chandra G Bertram, Andrew J K Williams, Marie E Mathers, Asok Biswas
Nicolau syndrome is a rare form of iatrogenic cutaneous necrosis which affects injection sites. Although classically associated with intramuscular injections, it may develop after subcutaneous or other routes of parenteral drug administration. Clinically, it manifests as necrotic ulcers that often develop in a background of erythematous and livedoid reticular patches. The histopathologic characteristics of Nicolau syndrome are poorly documented in the dermatopathology literature and features only rarely as one of the obscure causes of cutaneous thrombotic vasculopathy...
March 2018: American Journal of Dermatopathology
Dorlan J Kimbrough, Scott D Newsome
We report two cases of Nicolau syndrome (embolia cutis medicamentosa), a rare complication of injectable medications, both associated with the administration of 20 mg of subcutaneous glatiramer acetate. Both patients required surgical debridement and were subsequently treated conservatively without additional complications. Patient 1 opted to discontinue disease-modifying therapy. Patient 2 continued glatiramer acetate therapy without complications by using other injection sites. These cases highlight the need for prompt investigation of new unusual skin lesions in patients receiving injectable multiple sclerosis treatments (regardless of length of treatment and previous minor cosmetic concerns) and illustrate the clinical distinction between Nicolau syndrome and drug-induced skin necrosis...
May 2017: International Journal of MS Care
Paola C Stefano, Mónica Garello, María F Nolte, Patricia Lamy, Norberto Giglio, Vanesa Castellano, Ángela Gentile
Nicolau syndrome, also known as embolia cutis medicamentosa or livedo-like dermatitis, is a sudden tissue necrosis, a rare complication of intramuscular injection of some drugs. We report a case of a 6-month-old girl who received intramuscularly the third dose of hexavalent vaccine (DTaP- HVB-IPV/HIb), and immediately presented a livedoid lesion around the injection site, progressing to necrosis. We reinforce the importance of early diagnosis to perform a suitable treatment and clinical follow-up to avoid ischemic secondary complications...
February 1, 2017: Archivos Argentinos de Pediatría
Christo Tsekov, Anelia Loukova, Valeri Gelev
The paper reports successful thrombolysis conducted in 64 years old woman admitted to the clinic with clinical and angiographic data for acute surgical abdomen caused by acute tromboembolia of arteria mesenterica superior (AMS). The therapeutic approach required to undertake lifesaving decision on i.e. surgical vs. invasive treatment in conditions of emergency. Finally, it was decided to undertake invasive treatment with successful restoration of blood flow in the related artery. The patient was discharged from the clinic with considerable clinical improvement on the fifth day of her stay...
June 2016: Turkish Journal of Emergency Medicine
Tanya T Khan, Betsy Colon-Acevedo, Pradeep Mettu, Claudio DeLorenzi, Julie A Woodward
BACKGROUND: Embolia cutis medicamentosa (ECM) is a rare phenomenon attributed to intra-arterial drug injection. Glabellar filler injections can result in potentially devastating visual loss from inadvertent retrograde arteriolar embolization due to the extensive vasculature within the upper face. The minimum amount of filler necessary to potentiate this complication has not yet been reported. OBJECTIVES: We aim to determine the volume of filler necessary to occupy the supratrochlear artery from the glabella to the bifurcation of the ophthalmic and central retinal arteries...
February 2017: Aesthetic Surgery Journal
Sila Seremet, Enver Turan, Asli Turgut Erdemir
Nicolau syndrome, also known as embolia cutis medicamentosa, is a well known but very rare complication occuring after intramuscular drug injections and presenting with local intense pain. Immediately after injection the skin blanches and within minutes to hours an erythematous macule develops, which evolves into a livedoid violaceous patch with dendrites. This condition is initially hemorrhagic, then it ulcerates, and eventually heals with an atrophic scar. Many different drugs have been reported to cause Nicolau syndrome ...
August 15, 2015: Dermatology Online Journal
Loes M C F Bieleveld, Marjan J W Aldenzee
A 23-year-old woman developed painful skin necrosis after injections with lauromacrogol 400 for varicose veins. This complication, called embolia cutis medicamentosa or Nicolau syndrome, is characterised by acute pain and necrosis of the skin, subcutaneous tissue and muscle. Surgical intervention by local excision seems to be the best therapy.
2015: Nederlands Tijdschrift Voor Geneeskunde
İnci Kılıç, Füruzan Kaya, Ayşe T Özdemir, Tuğba Demirel, İlhami Çelik
INTRODUCTION: Nicolau syndrome, also known as livedo-like dermatitis or embolia cutis medicamentosa, is a rare complication following the intramuscular or intra-articular injection of various drugs. CASE PRESENTATION: In our case report we report the case of a 45-year-old Turkish woman who developed Nicolau syndrome after an intramuscular injection in her right gluteal region of single-dose diclofenac sodium to treat a headache. A culture taken from the ulcer showed growth of methicillin-sensitive Staphylococcus aureus on the 10th day...
2014: Journal of Medical Case Reports
D Jurisch, J G Kluge, D Pfeiffer
HISTORY: A 32-year-old woman was admitted to the emergency department because of acute dyspnea and syncope. A few minutes before the onset of symptoms, she had self-administered an intravenous injection of one gram of heroin combined with grinded flunitrazepam tablets. INVESTIGATIONS: Signs of acute cor pulmonale were detected on transthoracic echocardiography despite lack of pulmonary embolism in computed tomography. It was assumed that microembolisms were the cause of acute pulmonary hypertension after intravenous injection of heroin and flunitrazepam...
May 2013: Deutsche Medizinische Wochenschrift
Daniel Perli, Catharine Martone, Alwyn Rapose
Nicolau syndrome-also known as Embolia Cutis Medicamentosa-is a rare complication of intramuscular and subcutaneous injections manifesting as necrosis of skin and the underlying tissues. The exact pathogenesis is uncertain. There are several hypotheses including direct damage to the end artery, cytotoxic effects of the implicated drug or additives in the injectable preparations. Naltrexone is a long-acting opioid antagonist used primarily in the management of alcohol and opioid dependence. The patient received intramuscular naltrexone for treatment of alcoholism...
2012: BMJ Case Reports
C Guarneri, V Bevelacqua, G Polimeni
No abstract text is available yet for this article.
November 2012: QJM: Monthly Journal of the Association of Physicians
Jan-Falco Wilbrand, Martina Wilbrand, Heidrun Schaaf, Hans-Peter Howaldt, Christoph-Yves Malik, Philipp Streckbein
INTRODUCTION: Embolia cutis medicamentosa (Nicolau syndrome) is a rare iatrogenic event of tissue necrosis after intramuscular or intraarticular application of cristalloid suspensions. Clinically, it presents as a livid discoloration of the skin, local pain, and signs of inflammation. METHODS: This article presents the first case of Nicolau syndrome after the endodontic application of calcium hydroxide paste into the distal root canal of tooth 18. The patient presented to the Department for Maxillofacial Surgery and hospitalized for several days...
June 2011: Journal of Endodontics
P Mueller, C Forner, G Kurze
No abstract text is available yet for this article.
March 2012: Klinische Pädiatrie
Alyne Mendonça Marques Silva, Angelo Ton, Thaisa Faustini Loureiro, Brunella Lemos Agrizzi
Nicolau syndrome also known as Embolia cutis medicamentosa and Livedoid dermatitis is a rare complication characterized by tissue necrosis that occurs after injection of medicines. We describe a case of late development of Nicolau syndrome following intra-articular infiltration with corticosteroid.
January 2011: Anais Brasileiros de Dermatologia
Hee-Jin Park, Mi-Sung Kim, Noh-Hyuk Park, Sang-Won Jung, Sung-Il Park, Chan-Sub Park
Nicolau syndrome (also known as embolia cutis medicamentosa and livedoid dermatitis) is a rare but severe localized adverse drug reaction of intramuscular injection of various drugs. The typical presentation is pain around the injection site soon after injection, followed by erythema, livedoid patch, hemorrhagic patch, and finally necrosis of skin, subcutaneous fat, and muscle tissue. We report a case that occurred in a 34-year-old woman after intramuscular injection of diclofenac sodium. Sonography showed diffuse thickening with increased echogenicity of the skin and subcutaneous fat layer, while MRI revealed extensive edema involving gluteal and piriformis muscles and deep fascia, and fluid collection...
February 2011: Journal of Clinical Ultrasound: JCU
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