Penicillin is so widely used in antisyphilitic treatment that it is inevitable to have reactions occur in some instances. The Herish-Herxheimer reaction is negligible, especially if the penicillin is used at the beginning of treatment in small doses and if the patient has received some previous treatment with a bismuth compound. For the most part the reactions are allergic, usually so severe that penicillin therapy has to be discontinued.
REPORT OF CASE
H. J., a man aged 56, was married but had no children. Apparently he had been healthy all his life. The last serologic test for syphilis had been made thirty-five years ago and resulted negatively. The patient denied having had an initial lesion on the penis or any rash on his body. He had difficulty in breathing, had pain across the chest occasionally and tired easily. He appeared ill. Pulsations of the blood vessels in his neck were
GARAI F. SUCCESSFUL DESENSITIZATION TO PENICILLIN. JAMA. 1949;141(1):25–26. doi:10.1001/jama.1949.62910010005005d
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