Presentation
Two case reports and a review of the literature will be presented to alert clinicians to this reaction. Suggestions for management will also be offered. [ncbi.nlm.nih.gov]
Hematological
- Easy Bruising
bruising/bleeding, signs of kidney problems (such as change in the amount of urine), numbness/tingling of arms/legs, seizures, uncontrolled movements, confusion. [webmd.com]
Entire Body System
- Fever
BACKGROUND: Benzathine penicillin G every 3 weeks is the standard protocol for secondary prophylaxis for recurrent rheumatic fever. [ncbi.nlm.nih.gov]
- Swelling
Side Effects Pain/redness/swelling at injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. [webmd.com]
Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine. [mayoclinic.org]
Get emergency medical help if you have signs of an allergic reaction: hives; fever, chills, joint pain; difficult breathing; swelling of your face, lips, tongue, or throat. [umcvc.org]
- Intravenous Administration
We report a child with a 6-year history of linear morphea in whom intravenous administration of 5 MU aqueous penicillin G three times a day for 10 consecutive days caused reduction in the thickness of the corium as demonstrated by ultrasound measurements [ncbi.nlm.nih.gov]
Pain and sterile inflammation can occur at the site of intramuscular injection; phlebitis or thrombophlebitis sometimes follows intravenous administration of benzylpenicillin. [apps.who.int]
• Inadvertent administration by the intravenous route has been associated with cardiorespiratory arrest and death. • Fatal reactions to BPG have been rarely reported since the 1950's. [frontiersin.org]
THERE HAVE BEEN REPORTS OF INADVERTENT INTRAVENOUS ADMINISTRATION OF PENICILLIN G BENZATHINE, WHICH HAS BEEN ASSOCIATED WITH CARDIORESPIRATORY ARREST AND DEATH. [rxwiki.com]
administration, which has been associated with cardiorespiratory arrest and death reported; do not inject drug intravenously or admix with other intravenous solutions Prior to administration, carefully read the warnings, adverse reactions, and dosage [reference.medscape.com]
- Malaise
Report skin rashes, itching, fever, malaise, and other signs of a delayed reaction to physician immediately (see ADVERSE EFFECTS ). Penicillin is to be taken around the clock (i.e., t.i.d. means q8h, q.i.d. means q6h, etc.). [robholland.com]
• Know that in syphilis treatment, Jarisch-Hersheimer reaction (fever, chills, headache, sweating, malaise, hypotension or hypertension) may occur 2 to 12 hours after therapy begins and usually subsides within 24 hours. [medical-dictionary.thefreedictionary.com]
These complaints were accompanied by loss of appetite, weight loss and malaise. [scielo.isciii.es]
A serum sickness-like reaction has been reported, characterized by fever, malaise, urticaria, arthralgia, myalgia, lymphadenopathy and splenomegaly. [rxmed.com]
Manifestations of delayed reactions to penicillin included serum sickness-like symptoms, i.e., fever, malaise, urticaria, myalgia, arthralgia, abdominal pain, and various skin rashes (ranging from maculopapular eruptions to exfoliative dermatitis). [drugs.com]
- Unconsciousness
If the victim is convulsing or unconscious, do not give anything by mouth, ensure that the victim's airway is open and lay the victim on his/her side with the head lower than the body. DO NOT INDUCE VOMITING. [cameochemicals.noaa.gov]
Skin
- Skin Rash
Adverse effects Hypersensitivity reactions range in severity from skin rashes to immediate anaphylaxis. [apps.who.int]
Skin: Itchy palms or axilla, pruritus, urticaria, flushed skin, delayed skin rashes ranging from urticaria to exfoliative dermatitis, Stevens-Johnson syndrome, fixed-drug eruptions, contact dermatitis. [robholland.com]
Even though only small amounts may pass into breast milk, allergic reactions, diarrhea, fungus infections, and skin rash may occur in nursing babies. [drugs.com]
Side effects that you should report to your doctor or health care professional as soon as possible: allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue breathing problems dark urine fever with headache, flushing [my.clevelandclinic.org]
- Flushing
If not possible to separate doses, flush line well with sodium chloride 0.9% before and after giving doses. [rch.org.au]
Severe allergic reactions ; agitation; bizarre behavior; blood in urine; bloody stools; chest pain; chills; confusion; extreme tiredness; fainting; fast heartbeat; fever; flushing with lightheadedness or fainting; hallucinations; headache; itching; muscle [indiamart.com]
Notify your doctor right away if you experience any of these symptoms: fever/chills, muscle pain, worsening of skin sores, fast heartbeat, fast breathing, dizziness, flushing. [webmd.com]
- Urticaria
[Ref] Dermatologic Dermatologic side effects have included rash and urticaria. Contact dermatitis has been reported in those who prepared penicillin solutions. [drugs.com]
Skin: Itchy palms or axilla, pruritus, urticaria, flushed skin, delayed skin rashes ranging from urticaria to exfoliative dermatitis, Stevens-Johnson syndrome, fixed-drug eruptions, contact dermatitis. [robholland.com]
A serum sickness-like reaction has been reported, characterized by fever, malaise, urticaria, arthralgia, myalgia, lymphadenopathy and splenomegaly. [rxmed.com]
Typical allergic symptoms like urticaria or angioedema were missing in all cases. Three patients recovered, while in six cases the outcome was fatal despite intense resuscitation efforts. [frontiersin.org]
Another type of immediate reaction, an accelerated reaction, may occur between 20 minutes and 45 hours after administration and may include urticaria, pruritus, fever and, occasionally, laryngeal edema. [wikidoc.org]
- Sweating
• Know that in syphilis treatment, Jarisch-Hersheimer reaction (fever, chills, headache, sweating, malaise, hypotension or hypertension) may occur 2 to 12 hours after therapy begins and usually subsides within 24 hours. [medical-dictionary.thefreedictionary.com]
Tell your doctor right away if you have any of these symptoms: headache, fever/chills, sweating, joint/muscle pain, fast heartbeat, dizziness, worsening of skin sores or other disease symptoms. [webmd.com]
Common side effects may include: nausea, vomiting, diarrhea; itching, sweating, allergic reaction; flushing (sudden warmth, redness, or tingly feeling); feeling anxious, nervous, weak, or tired; headache, dizziness, drowsiness; muscle or joint pain; or [umcvc.org]
Call your doctor at once if you have: diarrhea that is watery or bloody; fever, swollen glands, rash or itching, muscle or joint pain, night sweats, general ill feeling; a feeling like you might pass out; skin rash with bruising, severe tingling, numbness [uofmhealth.org]
- Eczema
In individuals predisposed to develop allergic disease(s), the sequence of sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and bronchospasm) in infants and children less than 5 years due to food sensitivity [mayomedicallaboratories.com]
History of or suspected allergy (asthma, eczema, hay fever, hives); history of allergy to cephalosporins; kidney or liver dysfunction, myasthenia gravis, epilepsy, neonates, young infants. Use during lactation may lead to sensitization of infants. [robholland.com]
Make sure you tell your doctor if you have any other medical problems, especially: Allergy, general (such as asthma, eczema, hay fever, hives), history of—Patients with a history of general allergies may be more likely to have a severe reaction to penicillins [drugs.com]
Make sure you tell your doctor if you have any other medical problems, especially: Allergy, general (such as asthma, eczema, hay fever, hives ), history of—Patients with a history of general allergies may be more likely to have a severe reaction to penicillins [goodrx.com]
Urogenital
- Hematuria
Irritable urological symptoms with gross hematuria and bilateral lumbar pain developed when the patient received penicillin G for endocarditis. These symptoms were followed by renal insufficiency. [ncbi.nlm.nih.gov]
[Ref] Genitourinary Genitourinary side effects have included hematuria, proteinuria, and eosinophiluria.[Ref] Dermatologic Dermatologic side effects have included rash and urticaria. [drugs.com]
palpitations, tachycardia, cardiac arrest, pulmonary embolism EENT: blurred vision, vision loss, laryngeal edema GI: nausea, vomiting, diarrhea, epigastric distress, abdominal pain, colitis, blood in stool, glossitis, pseudomem-branous colitis GU: hematuria [medical-dictionary.thefreedictionary.com]
Report oliguria, hematuria, and changes in I&O ratio. Consult physician regarding optimum fluid intake. Dehydration increases the concentration of drug in kidneys and can cause renal irritation and damage. [robholland.com]
Renal: Rarely, acute interstitial nephritis (fever, proteinuria and hematuria); high doses of parenterally administered penicillin sodium or potassium may result in electrolyte disturbances, especially in patients with poor renal function. [rxmed.com]
Neurologic
- Seizure
Gram negative cocci Spirochaetes Prophylaxis: endocarditis orthopaedics surgery post splenectomy CONTRAINDICATIONS hypersensitivity resistant organism high dose in renal dysfunction ADVERSE EFFECTS superinfection (pseudomembranous colitis) GI upset seizures [lifeinthefastlane.com]
Psychosis and/or seizures following the administration of intramuscular penicillin G procaine have not been reported in the pediatric literature to our knowledge. [ncbi.nlm.nih.gov]
CSF penicillin levels ranged from 12 to 61 units/mL in the seizure group with the highest CSF concentrations, compared to 7.8 units/mL in the group without seizures. [drugs.com]
If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. [nlm.nih.gov]
Workup
For each subject, the leukocyte count, platelet count, and blood and superficial specimen cultures were performed as part of the routine workup. Pharmacokinetics study. The pharmacokinetics of penicillin G were studied on day 3 of life. [aac.asm.org]
Serum
- Neutropenia
OBJECTIVES: Penicillin G with an aminoglycoside is the standard initial empirical treatment in febrile neutropenia in Norway. [ncbi.nlm.nih.gov]
Neutropenia resolved after penicillin was discontinued. [drugs.com]
Interstitial nephritis, neutropenia and thrombocytopenia have been reported. Overdosage Overdosage can cause convulsions, paralysis and even death. Emesis and gastric lavage may be of value if begun within a few hours of injection. [apps.who.int]
Common adverse reactions include hypersensitivity reactions, hemolytic anemia, nausea, vomiting, stomatitis, neutropenia, hypereflexia, seizures, interstitial nephritis, thrombophlebitis. [wikidoc.org]
Microbiology
- Listeria Monocytogenes
These agents retain activity against streptococcal species, but also exhibit better activity against Enterococcus spp. and Listeria monocytogenes when compared to the natural penicillins. [news-medical.net]
Viridans Group ≤ 0.12 0.25 – 2 ≥ 4 - - - Listeria monocytogenes ≤ 2 § - - - - - Bacillus anthracis ¶ ≤ 0.12 - ≥ 0.25 - - - A report of Susceptible (S) indicates that the antimicrobial drug is likely to inhibit growth of the pathogen if the antimicrobial [web.archive.org]
[…] infections including meningitis and endocarditis Listeria monocytogenes Pasteurella infections including bacteremia and meningitis Pasteurella multocida Haverhill fever Streptobacillus moniliformis Rat bite fever Spirillum minus or Streptobacillus moniliformis [druglib.com]
Other organisms susceptible in vitro to penicillin G are Neisseria gonorrhoeae, Corynebacteriumdiphtheriae, Bacillus anthracis, clostridia, Actinomyces species, Spirillum minus, Streptobacillusmonillformis, Listeria monocytogenes, and leptospira; Treponemapallidum [wikidoc.org]
monocytogenes Usual Adult Dose for Meningitis Streptococci infection: 12 to 24 million units/day IV in equally divided doses every 4 to 6 hours Staphylococci infection: 5 to 24 million units/day IV in equally divided doses every 4 to 6 hours Listeria [drugs.com]
Treatment
Abstract Doxycycline is the preferred recommended second-line treatment for the treatment of early syphilis. Recent reports showed a declining efficacy trend of doxycycline in treatment of early syphilis. [ncbi.nlm.nih.gov]
Prognosis
Valvular sequelae is the most dreadful consequence of acute rheumatic fever, and such cardiac lesions can also predispose a patient to infective endocarditis (IE), a morbid disease that worsens the prognosis of these patients1-4. [scielo.br]
Etiology
Regarding the etiology of pneumonia based on the final results of microbial investigation, 46 cases (65.7%) were Streptococcus pneumoniae, and 17 (24.3%) were of an undetermined etiology. [bmcresnotes.biomedcentral.com]
[…] treatment of pneumococcal pneumonia, penicillin G is seldom used for this purpose in clinical practice for at least three reasons: (1) concern about penicillin-resistant Streptococcus pneumoniae (PRSP) strains; (2) the difficulty of making an early etiologic [ncbi.nlm.nih.gov]
Página 330 - Intestinal infections in patients with the acquired immunodeficiency syndrome (AIDS): etiology and response to therapy. [books.google.es]
Interpretation Provides information to assist in interpretation of the test results Detection of IgE antibodies in serum (Class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens [mayomedicallaboratories.com]
This is evidence of the lack of BPG influence on the most prevalent microorganism in the bacterial plaque and one of the main Infectious Endocarditis etiological agents20,21,26. [scielo.br]
Epidemiology
Category Pharmacology Penicillin antibiotic as 0.6 MIU, 1.2 MIU and 2.4 MIU powder and solvent for suspension for injection Epidemiology There were 5,288 new diagnoses of syphilis in England in 2015, a 19.9% increase from 4,412 in 2014. [sps.nhs.uk]
This investigation was conducted under the sponsorship of the Commission on Streptococcal Diseases, Armed Forces Epidemiological Board. It was supported by the Office of the Surgeon General, departments of the Army and Air Force, Washington, D. [nejm.org]
Washington, DC American Society for Microbiology (pg. 739 - 45 ) 16 Epidemiological section, Khon Kaen Provincial Health Office ., Annual epidemiological surveillance report, Khon Kaen province, 2000 Khon Kaen Khon Kaen Hospital pg. 112 17 Computer and [academic.oup.com]
In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. DOSAGE AND ADMINISTRATION Penicillin G potassium may be given intravenously or intramuscularly. [druglib.com]
Pathophysiology
Página 302 - Groszmann RJ, Atterbury CE: The pathophysiology of portal hypertension: a basis for classification. Semin Liver Dis 1982; 2:177. [books.google.es]
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators [mayomedicallaboratories.com]
The most likely pathophysiologic explanation for these fatalities is that the BPG compound is a crystalline powder that may cause direct damage when injected into a blood vessel, possibly eliciting vascular spasm and subsequent occlusion by the large [frontiersin.org]
Sickle cell disease – pathophysiology and treatment. Curr Probl Pediatr Adolesc Health Care. 2006;36:346–376. [PubMed] [Google Scholar] 30. Halasa NB, Shankar SM, Talbot TR, et al. [ncbi.nlm.nih.gov]
Prevention
CONCLUSION: A single 1.0-g dose of azithromycin seems to be efficacious for prevention of syphilis in persons exposed to infected sexual partners. [ncbi.nlm.nih.gov]
(via heterocyclic antibiotic ) antibacterial drug A drug used to treat or prevent bacterial infections. drug allergen Any drug which causes the onset of an allergic reaction. [ebi.ac.uk]