Nicolaou syndrome in a woman in partury

Abstract

The article presents a clinical case of a rare iatrogenic complication associated with intramuscular or subcutaneous administration of drugs — drug embolism of soft tissues (Nicolaou syndrome). This complication occurred in a woman in labor on the second day after a cesarean section due to the injection of a non-steroidal anti-inflammatory drug for pain relief in the postoperative period. The clinical picture was characterized by the appearance of pain syndrome and swelling of the anterior surface of the right thigh (in the area of the drug injection). According to the ultrasound examination of the soft tissues of the right thigh, moderate thickening of the skin was visualized in the area of the affected tissue; at a depth of 26 mm from the skin surface in the thickness of the muscle — an area of high echogenicity measuring 48 × 5 mm; however, fluid accumulations, as well as cavity formations in the soft tissues were not detected. Against the background of antibacterial, anticoagulant therapy and drug analgesia, positive dynamics, a decrease in the severity of edema and intensity of pain syndrome were noted.