In three patients, systemic allergic reactions developed following inhalation of small amounts of penicillin. In one case, the cause was clinically not readily apparent, and intradermal testing led to a severe systemic reaction. Reagin titers confirmed the high degree of penicillin sensitivity.
Reisman RE, Arbesman CE. Systemic Allergic Reactions Due to Inhalation of Penicillin. JAMA. 1968;203(11):986-987. doi:10.1001/jama.1968.03140110078022