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[Hoigne's syndrome].

P Gaig1, M J Paniagua

  • 1Servicio de Medicina Interna, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain. pgaigj@hjxxiii.scs.es

Allergologia Et Immunopathologia
|March 22, 2005
PubMed
Summary
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Hoigne's syndrome is a rare pseudoallergic reaction to penicillin injections. This case highlights key symptoms like hallucinations and confusion, differentiating it from true anaphylaxis.

Area of Science:

  • Pharmacology
  • Neurology
  • Toxicology

Background:

  • Hoigne's syndrome is a pseudoanaphylactic reaction following intramuscular penicillin G procaine or benzathine.
  • It is often an embolic toxic reaction caused by vascular occlusion from penicillin salt crystals.

Observation:

  • A 44-year-old woman experienced acute mental confusion, visual/auditory hallucinations, body image distortion, tongue swelling, and fear of death after penicillin injection.
  • Diagnostic evaluation included penicillin allergy studies, with a negative oral challenge test confirming the diagnosis.

Findings:

  • Hoigne's syndrome presents with neurological and psychological symptoms, distinct from IgE-mediated anaphylaxis.
  • The reaction is linked to the physical properties of penicillin salt crystals rather than a true allergy.

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Implications:

  • Accurate differentiation between Hoigne's syndrome and anaphylactic shock is crucial for patient management.
  • Continued penicillin therapy is permissible in Hoigne's syndrome, unlike in true anaphylaxis, where it is contraindicated.