RT Journal A1 Jackson FN, Jaffe JP T1 FAtal penicillin-induced hemolytic anemia JF JAMA JO JAMA YR 1979 FD November 23 VO 242 IS 21 SP 2286 OP 2287 DO 10.1001/jama.1979.03300210014008 UL http://dx.doi.org/10.1001/jama.1979.03300210014008 AB To the Editor.—  Since the first report of a circulating antipenicillin antibody by Ley et al1 in 1958, more than 20 cases of immunohemolytic anemia due to antipenicillin antibodies have been reported. In most cases, the antibody was an IgG related to prolonged high-dose penicillin therapy,2 and, although several of the hemolytic episodes were severe, there have been no reported deaths directly attributable to penicillin-induced hemolysis. We report here a case of circulatory collapse and death in a patient with Coombs-positive hemolytic anemia and circulating antipenicillin antibodies.Report of a Case.—  A 54-year-old woman was hospitalized with cellulitis, fever, aseptic meningitis, a peripheral embolic phenomenon, and dehydration. On admission, the hematocrit value was 31%; hemoglobin level, 10.1 g/dL; and WBC count, 15,600/cu mm, with a left shift. The patient initially received aqueous penicillin G, 3 million units intravenously (IV) every four hours. After rehydration, the hematocrit value was