If too high a concentration of penicillin is applied, acute penicillin allergy-like symptoms of varying degrees can occur in patients with lower immunity or poorer physical condition. Patients will have red, swollen, hot, painful skin and with itchy skin with allergic macules, papules, or even allergic urticaria with scratches on it, and in severe cases, vesicles and oozing. In severe cases of high penicillin concentration, which produces secondary allergy, there is also chest tightness, shortness of breath, palpitations, and discomfort in the precordial area, accompanied by dyspnea. Severe cases can also lead to anaphylactic shock, with a drop in blood pressure, rapid pulse, pallor, cold and clammy extremities, and decreased urine output, at which time epinephrine must be applied for timely resuscitation, and the patient must be given oxygen throughout and penicillin infusion stopped.