Severe Immediate Constitutional Reaction to Penicillin

Although unfavorable reactions to penicillin therapy are well known, the occurrence and frequency of serious, life-threatening, immediate constitutional reactions are not generally recognized. The few published reports describe two principal types of prompt systemic reaction. Fatal and near-fatal penicillin anaphylaxis has recently been reviewed by Siegal, Steinhardt, and Gerber.¹An anaphylactic-like shock state, occasionally fatal, was discussed in a recent issue ofThe Journalby Mayer and others,²and similar cases have been recorded.³An entirely different type of reaction, characterized by sudden weakness and angor animi and with no recognizable evidence of hypersensitivity or circulatory or respiratory disturbance, has been described by Batchelor, Home, and Rogerson.⁴The fact that Mayer's group observed six cases within a relatively short period of time and Batchelor's group encountered eight cases over an interval of seven months (an incidence of three cases per thousand injections) suggests that severe immediate