PROPUESTA PARA EL DIAGNÓSTICO PRECOZ DEL SÍNDROME DE NICOLAU EN NIÑOS DE 2 A 23 MESES
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Introducción: El síndrome de Nicolau (SN), es una patología de etiología desconocida. Que inicia por una reacciona adversa posterior a la administración de medicación, por personal de salud, a pesar de ser este procedimiento parte de la práctica diaria. Objetivo: Establecer una propuesta para el diagnóstico precoz del SN en base a las manifestaciones clínicas. Métodos: Investigación de diseño documental, descriptivo y exploratorio, a través de revisión de artículos científicos, en bases de datos científicas como Scopus, Elsevier, Scielo, MEDLINE/Pubmed, Proquest, Medline, SciFinder, Springer y Biblioteca Virtual en salud Ecuador, utilizando las palabras clave: síndrome de Nicolau, diagnóstico precoz, terapia combinada. Desarrollo: El SN, presenta 3 fases, la inicial, caracterizada por edema leve, eritema y dolor continuo en los sitios de aplicación del medicamento. En los niños debilidad de miembros inferiores, una hora después del cumplimiento de la medicación, acompañado de incontinencia urinaria y fecal. La fase aguda, se presenta en 1 a 3 días con una placa livedoide endurecida en la zona afectada. La fase necrótica, aparece entre los 5 a 14 días, con ulceración en el área, formación de tejido de granulación y secreción purulenta, se puede desarrollar gangrena y mionecrosis muscular. El diagnóstico es clínico, complementado por biopsia, ecosonograma, ultrasonografía doppler y angiografía por tomografía. No existe protocolo terapéutico específico para la patología. Conclusiones: La elaboración de un diagrama para la identificación temprana del síndrome de Nicolau basado en la sintomatología, ayudara al personal de salud y padres de familia a un diagnóstico precoz, evitando complicaciones severas
Palabras clave: Síndrome de Nicolau, diagnóstico precoz, terapia combinada.
ABSTRACT
Introduction: Nicolau syndrome (SN) is a pathology of unknown etiology. That begins with an adverse reaction after the administration of medication by health personnel, despite the fact that this procedure is part of daily practice. Objective: To establish a proposal for the early diagnosis of NS based on clinical manifestations. Methods: Documentary, descriptive and exploratory design research, through the review of scientific articles, in scientific databases such as Scopus, Elsevier, Scielo, PubMed, Proquest, MEDLINE/Pubmed, SciFinder, Springer and Virtual Health Library Ecuador, using the words key: Nicolau syndrome, early diagnosis, combined therapy. Development: The NS, presents 3 phases, the initial, characterized by mild edema, erythema and continuous pain in the sites of application of the medication. In children, weakness of the lower limbs, one hour after compliance with the medication, accompanied by urinary and fecal incontinence. The acute phase occurs in 1 to 3 days with a hardened livedoid plaque in the affected area. The necrotic phase appears between 5 to 14 days, with ulceration in the area, formation of granulation tissue and purulent secretion, gangrene and muscle myonecrosis may develop. Diagnosis is clinical, supplemented by biopsy, echosonography, Doppler ultrasonography, and computed tomography angiography. There is no specific therapeutic protocol for the pathology. Conclusions: The elaboration of a diagram for the early identification of Nicolau syndrome
based on symptomatology, will help health personnel and parents to an early diagnosis, avoiding severe complications.
Keywords: Nicolau Syndrome, early diagnosis, combined therapy
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