Diclofenac
- PDF / 170,259 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 55 Downloads / 208 Views
1 S
Diclofenac Nicolau syndrome due to improper administration of IM diclofenac injection: case report
A 60-year-old man developed Nicolau syndrome following improper administration of IM diclofenac injection for generalised body ache. The man was admitted to a hospital in India with complaints of severe pain in the right gluteal region. Anamnesis revealed that he recently had received IM injection of diclofenac 2mL (75mg) for generalised body ache at an unknown local clinic in India. Immediately after receiving IM injection, he developed sudden pain at injection site, which was radiating towards right lower limb. The pain was continuous and moderate in intensity. He also developed difficulty in walking after the injection. The intensity of the pain was 9 on 10 as per Visual Analog Scale (VAS). Within 8 hours of the injection, he developed pallor, swelling and bluish black skin discolouration [exact time to reaction onset not stated]. Upon admission, a physical examination showed tenderness on the right gluteal region extending to femoral region without fever or swelling. Following an attempt of aspiration from the swollen site, no aspirate was noted. The man was conservatively managed with ceftriaxone/sulbactam, mecobalamin/pregabalin considering a possibility of radiculopathy, and tramadol, paracetamol and unspecified topical gel for the pain. On the second day, his pain extended upto the left ankle. On day 3, the injection site became dark-red with a visible haemorrhagic patch. The laboratory findings showed elevated erythrocyte sedimentation. Ultrasound surface scan showed mildly bulky and oedematous right gluteus maximus muscle. The same therapy was then continued. By day 5, erythematic area reduced and changed to progressive dark discolouration of the skin. He was afebrile during the hospital stay. Based on the clinical presentation, a diagnosis of Nicolau syndrome due to improper administration of IM injection of diclofenac was confirmed [outcome not stated]. Rodrigues A, et al. Nicolau syndrome: A rare event following intramuscular diclofenac. JK Science 22: 101-103, No. 2, Apr-Jun 2020. Available from: URL: http:// www.jkscience.org/archives/volume222/13-Case%20Report.pdf
0114-9954/20/1819-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
803498346
Reactions 29 Aug 2020 No. 1819
Data Loading...
