Immediate nonallergic psychotic reaction to intramuscular procaine penicillin.

Abstract:

BACKGROUND:Though little known by medical personnel, an immediate nonallergic psychotic reaction to intramuscular procaine penicillin has been reported occasionally from many countries since 1951. MATERIALS AND METHODS:A case report describes a patient whose violent behavior, provoked by this reaction, resulted in legal action taken against him. Two other nonviolent cases are presented and are followed by a review of the literature. RESULTS:Signs and symptoms of this reaction that appears to be to the procaine component resemble a pressor response and are therefore contrary to the signs and symptoms of an anaphylactic reaction. Anxiety, hallucinations, hypertension, and tachycardia are characteristic. The reaction is self-limited. Long-term psychologic sequelae might be averted by adequate reassurance. CONCLUSIONS:The importance of procaine penicillin as an essential drug in many parts of the world should not be diminished; however, recognition of acute nonallergic psychotic reactions is of paramount importance to assure proper patient management and to avoid misinterpretation of aggressive behavior.

journal_name

Int J Dermatol

authors

Einterz EM,Einterz RM

doi

10.1111/j.1365-4362.1995.tb01089.x

subject

Has Abstract

pub_date

1995-09-01 00:00:00

pages

627-9

issue

9

eissn

0011-9059

issn

1365-4632

journal_volume

34

pub_type

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