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An ‘epidemic’ of aseptic peritonitis occurred in our peritoneal dialysis unit, affecting 5 of 20 patients. Acute and convalescent viral titers were normal in all 5. The peritoneal fluid of the affected patients was not tested for endotoxin, but endotoxin was found in subsequent dialysis fluids from two machines in the unit. This endotoxin might have been the causative agent of this outbreak. Rapid recovery ensued in all patients following peritoneal lavage.

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Although penicillin is a relatively safe drug, many reactions, including three deaths (1-3), have been reported following its administration. Most of these reactions appear to be allergic in origin, even though the nature of the antigen has usually not been determined. During the years that penicillin was being purified many reactions were considered to be caused by impurities, particularly when the reaction was specific for a particular lot. When slowly absorbable preparations became available it seemed important to determine whether administration in this form increased the incidence of reactions. We have undertaken a study to determine the reaction rate to crystalline penicillin in aqueous solutions and to slowly absorbable forms as seen in ordinary hospital practice as well as factors influencingthe incidence of such reactions and the nature of the antigen involved. In the present paper we are reporting the. incidence of reactions which we have found and some of the factors believed to be important in determining the reaction rate. Studies on skin tests with penicillin oil and beeswax will be reported elsewhere (4). METHODThe method of this study was to observe daily all patients being treated with a preparation containing penicillin. Before treatment was initiated the patients were questioned regarding previous courses of penicillin and previous allergic reactions. A physical examination was then performed and the type of preparation, the dose, and the lot number of the penicillin employed were recorded.At least once a day each patient was examined and questioned closely regarding signs and symptoms of allergic reactions and of reactions at the site of injection.