Penicillin hypersensitivity with eosinophilia. A case report with immunologic studies

Jean Pierre Girard, Marie L. Kunz, Satsuo Kobayashi, Noel R. Rose, Carl E. Arbesman

Research output: Contribution to journalArticlepeer-review

Abstract

A case of penicillin hypersensitivity with marked eosinophilia and a transient skin rash is presented. The patient continued to receive large doses of penicillin intravenously for treatment of subacute bacterial endocarditis, and underwent successful open-heart surgery with replacement of the mitral valve. By means of the passive hemagglutination technic, direct skin tests and Schultz-Dale technic using unheated, heated and mercaptoethanol-treated serum, it was possible to demonstrate antibodies to penicillin in both IgG and IgM immunoglobulins during the first three months of the illness. At the thirtieth week only skin-sensitizing antibodies (probably IgA) to penicillin were demonstrable by these technics. The peripheral lymphocytes in a five day culture were stimulated and showed blast cell transformation when either penicillin G or penicilloyl polylysine was added. Direct Schultz-Dale experiments with the patient's cardiac muscle showed a contraction when penicillin G was added. This finding indicates the presence of anti-bodies fixed to the heart muscle. A strong contraction was observed with both the patient's and a control cardiac muscle when bradykinin, serotonin and epinephrine were added to the bath, but these tissues seem to be relatively insensitive to the action of histamine.

Original languageEnglish (US)
Pages (from-to)441-448
Number of pages8
JournalThe American journal of medicine
Volume42
Issue number3
DOIs
StatePublished - Mar 1967

ASJC Scopus subject areas

  • Medicine(all)

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