In Reply.—The patient described in this letter clearly suffered from seizures secondary to the intramuscular injection of penicillin G procaine.1 He thus is probably the youngest patient reported with Hoigne's syndrome. A long-distance conversation with Dr Jalbert, confirmed, as was expected, that the patient remains fully recovered. An interesting aspect of this case is the fact that, at times, procaine may be given without the conscious awareness of the prescribing physician. When we first read that penicillin G benzathine (Bicillin C-R) was thought to be the cause of this patient's reaction, we were not sure about the presence of procaine in the preparation, until we consulted our Physicians' Desk Reference and confirmed that it contains 600,000 units of penicillin G procaine. Thus, it becomes very important to be alert to the possibility of antibiotic combinations with "hidden procaine." Unfortunately, we still lack a clear knowledge of why some
SILBER TJ, D'ANGELO L. Seizures After Penicillin Administration-Reply. Am J Dis Child. 1985;139(11):1075. doi:10.1001/archpedi.1985.02140130013014
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