This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

TOMAS J. SILBER, MD; LAWRENCE J. D'ANGELO, MD
Children's Hospital National Medical Center 111 Michigan Ave NW Washington, DC 20010

Am J Dis Child. 1986;140(6):503.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—Colonel Weir questions whether a true intramuscular injection could ever cause Hoigne's syndrome or whether this syndrome is actually provoked by inadvertent intravascular injection. The intramuscular route remains a possibility. Once in the organism, procaine and penicillin are rapidly separated by procaine esterase. The level of plasma procaine has been shown to be significantly raised immediately following the intramuscular injection of procaine penicillin (being undetectable only 30 minutes later).¹ However, there is no question that in at least some instances inadvertent intravascular injection may be responsible for the symptomatology. To support this viewpoint one can cite patients complaining about the "taste" of medication almost immediately after the injection.² Moreover, patients with cardiovascular insufficiency seem to constitute a risk group for the condition,³ suggesting the possibility of embolic phenomena. Indeed, anxiety, tinnitus, visual difficulty, and paresthesias have been described secondary to fat emboli, and therefore it . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?