[Arterial vascular occlusion in penicillin allergy (author's transl)]

A nodular exanthema of the skin was observed in an 8-year-old girl. She had been treated with penicillin a few days ago because of a gastrointestinal infection. Continuation of penicillin treatment led to occlusion of larger arteries with gangrene of the forefoot. This was accompanied by septic temperatures and superinfected skin lesions. Angiologic and angiographic investigations showed a right-sided femoro-popliteal occlusion and occlusions of the arteries of the lower leg. On the left side there was spasm of the superficial femoral artery. After cessation of penicillin and high-dose steroid therapy rapid restitution occurred. Arterial spasms regressed, the occlusions remained persistent, but there was adequate collateral blood supply and ischaemic acral necroses healed. An allergic reaction of the intermediary type involving major arteries can be considered causative underlying pathology.