Medicine: Penicillin Shock

The 39-year-old Detroit woman was being treated for asthma and bronchitis with penicillin. One day a nurse gave her a routine injection of 50,000 units. Within a few seconds the patient complained of a strange taste in her mouth, and of swelling and tightness in her throat and nose. She itched all over, and turned blue in the face. Then, as she was asking for a glass of water, she collapsed and died.

The case was reported last week in the Journal of the American Medical Association by Detroit Allergist George L. Waldbott. For 18 years Dr. Waldbott has been studying cases of fatal shock following shots of serums. The Detroit woman, he explains, was accidentally pierced in a vein (instead of a muscle) by the hypodermic needle. The penicillin was absorbed too rapidly into a system already sensitized to penicillin by previous injections.

Several other deaths due to "serum sickness" or delayed reaction to penicillin have been reported; the patients died five to eleven days later. But this was the first death reported due to "anaphylactic shock," i.e., immediate allergic reaction. There may have been others. Dr. Waldbott warns: "Not everybody would write up deaths in their own practice; and not everyone would recognize such a death as due to anaphylactic shock." His advice to physicians: check carefully to make sure the patient has not been sensitized to penicillin; if he has been, take extra care not to inject it into a vein.