Severe paraaminosalicylic acid hypersensitivity; blood and lymph node studies.

Fourteen patients of approximately 5,000 taking PAS imi this institution acquired a severe hypersensitivity to the drug. The reaction began 15 to 43 days after the beginning of therapy and all cases developed fever (100.2 to 105#{176} F.), rash and pruritus (table 1). The rash involved the face, neck, and extremities in the milder cases and was generalized in the severer ones. Usually it was erythematous, macular, or morbilliform, but in one case it was urticarial. The pruritus was fairly severe in all but 3 patients. Chills frequemitly accompanied the fever amid were severe in 4 cases. Nausea was experienced by most pat ients and burning of the eyes and lacrimation added to the discomfort of headache amid generalized aching. Cervical lymphadenopathy was noted in elevemi patiemits; axillary amid inguinal nodes were palpable in a few. Tenderness amid enlargement of the liver was found in 5 patients; three had a splenomegaly amid two had obvious jaumidice. It will be mioted from table 1 that there occurred considerable variation in the extent and intensity of the reaction. The case reports which folloi will further illustrate these variations.