Hoigne Syndrome describes an adverse drug reaction that occurs following accidental intravascular injection of certain drugs.
Synonym: pseudo-anaphylaxis, pseudo-allergy
Mechanism: believed to be a combination of (a) direct toxic drug effect and (b) formulation microemboli
Clinical features:
(1) The onset of symptoms following accidental intravascular injection of a drug. The first reports were for procaine penicillin being injected intramuscularly.
(2) The patient may develop (from 0 to 48 hours after the injection):
(2a) seizures
(2b) transient psychosis with hallucinations
(2c) anxiety, panic or phobia
(2d) mental confusion
(2e) depersonalization
(2f) impulsive or violent behavior
(3) no evidence for drug allergy on subsequent testing
Implicated drugs include:
(1) procaine penicillin
(2) lidocaine
(3) amoxicillin, azlocillin or other penicillin
(4) gentamicin
(5) clarithromycin
(6) cefuroxime
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