[Hypersensitivity to penicillin therapy in the course of treatment: a case report]

Adverse reactions to benzylpenicillin are well known. Full allergy testing is time-consuming, expensive and doesn't exclude anaphylaxis to penicillin. It is accepted that penicillin allergy is overdiagnosed. Therefore clinical observations are not useful for pathogenesis research without follow up examination. 100 patients with negative skin test before and with symptoms of penicillin hypersensitivity during treatment was diagnosed. We report only 4 cases of patients, whose allergy to penicillin was confirmed by the same skin test. They had received penicillin during serious bacterial infections and had experienced allergic symptoms. Skin rush, asthma or hypotension have been observed during treatment with penicillin. Immediate hypersensitivity was confirmed by positive skin test after treatment. This study reinforce findings of our experimental study, when intraperitoneal injections of penicillin and Freunds adjuvant or bacterial lysate lead to anaphylactic shock and death of guinea pigs. Eastaway et all published similar case report of gas gangrene complicated by penicillin allergy. These observations indicate that pathogenesis of penicillin allergy may be associated with bacterial infection and nonspecific inflammation.