African Journal of
Pharmacy and Pharmacology

  • Abbreviation: Afr. J. Pharm. Pharmacol.
  • Language: English
  • ISSN: 1996-0816
  • DOI: 10.5897/AJPP
  • Start Year: 2007
  • Published Articles: 2296

Case Report

Nicolau syndrome: An avoidable iatrogenic complication leading to disabilities

Manan Siméon YOBO-BI
  • Manan Siméon YOBO-BI
  • Clinical pharmacology, Department of Fundamental and Bioclinical Sciences, Bouaké University Hospital Center, Côte d'Ivoire.
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Kanga Sita N'ZOUÉ
  • Kanga Sita N'ZOUÉ
  • Clinical pharmacology, Department of Fundamental and Bioclinical Sciences, Bouaké University Hospital Center, Côte d'Ivoire.
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Massiré TOURÉ
  • Massiré TOURÉ
  • Clinical pharmacology, Department of Fundamental and Bioclinical Sciences, Bouaké University Hospital Center, Côte d'Ivoire.
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Adoubs Célestin BÉNIÉ
  • Adoubs Célestin BÉNIÉ
  • Pediatric Surgery, Department of Surgery and Specialties, Bouaké University Hospital Center, Côte d’Ivoire.
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Mankoh Yves-Cédric KEE
  • Mankoh Yves-Cédric KEE
  • Clinical pharmacology, Department of Fundamental and Bioclinical Sciences, Bouaké University Hospital Center, Côte d'Ivoire.
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Kpangni Ahua Jean BERTRAND
  • Kpangni Ahua Jean BERTRAND
  • Pediatric Surgery, Department of Surgery and Specialties, Bouaké University Hospital Center, Côte d’Ivoire.
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Alain Claude Stéphane Batoué TIA
  • Alain Claude Stéphane Batoué TIA
  • Clinical pharmacology, Department of Fundamental and Bioclinical Sciences, Bouaké University Hospital Center, Côte d'Ivoire.
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Mamadou KAMAGATE
  • Mamadou KAMAGATE
  • Clinical pharmacology, Department of Fundamental and Bioclinical Sciences, Bouaké University Hospital Center, Côte d'Ivoire.
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  •  Received: 20 March 2024
  •  Accepted: 14 June 2024
  •  Published: 31 July 2024

Abstract

Nicolau syndrome is a rare complication following intramuscular injection of various medications. The pathophysiology of the condition remains complex. However, corticosteroids are responsible for vasospasm and ischemic necrosis. The objective of this report was to demonstrate the often-preventable nature of this debilitating drug-induced iatrogenesis. Two cases of preventable Nicolau syndrome in children aged 2 and 6 years following an intramuscular injection of dexamethasone causing leg amputation in a context of misuse were notified by the pediatric surgery department of the University Hospital of Bouaké, Côte d'Ivoire. Although very rare, Nicolau syndrome, sometimes preventable, is responsible for numerous serious complications resulting in after-effects.

Key words: Nicolau syndrome, dexamethasone, preventability, disability, iatrogenicity