Nicolau syndrome after lumbar puncture: A case report in a 22-month-old girl

Nicolau syndrome (NS) is a rare, aseptic cutaneous necrosis that may involve the subcutaneous and muscle tissue layers.1 This syndrome is associated with intramuscular, subcutaneous, intravenous, and intra-articular injections of antibiotics, local anesthetics, glucocorticoids, nonsteroidal anti-inflammatory drugs, hyaluronic acid, vaccinations, and vitamins.2-5 NS presents as an immediate and severe pain at the injection site and a clearly demarcated livedolike discoloration of the skin that progresses to cutaneous necrosis with potential involvement of the underlying tissues.