In 1959 Hoigne described the first cases of pseudo-
anaphylactic reactions induced by intramuscular administration of
procaine penicillin G. This complication, characterized by acute psychological and
neurological manifestations, is still of current interest. We report cases of patient, whose Hoigne syndrome was not due to
procaine penicillin G (i.e.
lidocaine,
edan,
azlocillin,
gentamycin, klaritromycin and
cefuroxime). It is accepted that Hoigne syndrome can be caused by
lidocaine. Further Stell i.m. and Ojo OA published similar case report of
Amoxycillin-induced
hallucinations. These clinical observations indicate also that using term "acute non-
allergic reaction to
procaine penicillin G" as synonym of Hoigne syndrome is not precise. Further classification of the reaction among psychic disturbances or
adverse drug reactions is very difficult. Much of literature is devoted to the differentiation from
anaphylaxis rather than other symptoms of main disease or side effects. Harmful effect of main disease is very likely.
Lidocaine was taken intravenously by patient with diabetes and
heart attack or locally with
chronic hepatitis during topical
anesthesia.
Benzylpenicillin, azlocycillin,
gentamycin, klaritromycin and
cefuroxime was used during serious
bacterial infections. These observations indicate that pathogenesis of Hoigne syndrome may be associated with main disease and organic
brain disease. Then
procaine kindling mechanism partly explain Hoigne syndrome. Therefore pathogenesis, definition, differentiation and classification of this complication is still unclear.