Abstract
A case of fatal penicillin anaphylaxis with necropsy findings is presented. Outstanding pathologic features were serous myocarditis with round cell infiltration, pulmonary edema, emphysema and general vascular endothelial necrosis. Shock in penicillin anaphylaxis is treated immediately with epinephrine administered intravenously. When the blood pressure cannot be maintained above shock levels with epinephrine the pressor amine of choice is l-arterenol administered as a continuous infusion drip. Cortisone is the drug of choice in treating penicillin allergic reactions; antihistamines have limited value. The probable mechanism of the penicillin immune reaction is discussed.
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