Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar 21;8(1):33.
doi: 10.1038/s41394-022-00503-z.

Spinal cord ischaemia following the gluteal injection of Benzathine benzylpenicillin

Suha A N Osman  1 , Shyam S Swarna  2 , Kate Russell-Hobbs  3 , Sankar Hariharan  1 , Ayah M Babiker  1
Affiliations
Review

Spinal cord ischaemia following the gluteal injection of Benzathine benzylpenicillin

Suha A N Osman et al. Spinal Cord Ser Cases. .

Abstract

Introduction: Spinal cord injury is a devastating complication, though rare but possible following the intramuscular injection of the Penicillin. The spinal cord injury can be permanent, leaving the patient with paralysis, bowel and bladder incontinence, and with other associated morbidities.

Case presentation: We report a 25-year-old gentleman who developed anterior spinal cord syndrome following the benzathine benzylpenicillin injection. In this case report, we discuss the clinical details, possible hypothesis behind spinal cord ischaemia and literature review.

Discussion: Spinal cord ischaemia or infarction occurs due to embolism of the Penicillin products. The products following injection are carried as emboli retrogradely through the superior gluteal artery and can cause infarction to the cord's anterior part.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. T2 weighted saggital MRI scan of dorsolumbar scan.
MRI scan done on day 1 (dorso-lumbar spine).
Fig. 2
Fig. 2. MRI scan done on day 1 (lumbosacral spine).
MRI done (Figs. 1 and 2) on day 1 showed longitudinally extensive region of mildly expansile spinal cord signal abnormality within the lower thoracic spinal cord and conus covering T10–L1. The appearances suggestive of possibility of spinal cord ischaemia with differentials being longitudinally extensive transverse myelitis (LETM).
Fig. 3
Fig. 3. MRI scan done on day 2.
The distal cord and conus showing features suggestive of cord infarction.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kirshblum SC, Burns SP, Biering-Sorensen F, Donovan W, Graves DE, Jha A, et al. International standards for neurological classification of spinal cord injury (revised 2011) J Spinal Cord Med. 2011;34:535–46. doi: 10.1179/204577211X13207446293695. - DOI - PMC - PubMed
    1. Benzylpenicillin benzathine 2.4 Million I.U. powder and solvent for suspension for injection—Summary of Product Characteristics (SmPC)—(emc) (medicines.org.uk).
    1. Galpin JE, chow AW, Yoshikawa TT. “Pseudo anaphylactic reaction” from infusion of procaine Penicillin G. Ann Intern Med. 1974;81:358–9. doi: 10.7326/0003-4819-81-3-358. - DOI - PubMed
    1. Bell RC, Rannie I, Wynne NA. Adverse reactions to procaine penicillin in cats and man. Lancet. 1954;2:62–6. doi: 10.1016/S0140-6736(54)90053-7. - DOI - PubMed
    1. Silber TJ, D'Angelo LJ. Panic attack following injection of aqueous procaine penicillin G (Hoigne syndrome) J Peaditr. 1985;107:314. - PubMed

MeSH terms

Substances