Clinical Focus ›› 2023, Vol. 38 ›› Issue (10): 922-925.doi: 10.3969/j.issn.1004-583X.2023.10.011

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Type I Kounis syndrome caused by drug allergy: A case report

Yang Changlin, Cao Shufeng(), Qiao Lian, Zhao Huimin   

  1. Department of General Practice,970 Hospital of the PLA JLSF,Yantai 264000,China
  • Received:2023-05-13 Online:2023-10-20 Published:2024-01-03
  • Contact: Cao Shufeng E-mail:csf1004@126.com

Abstract: Objective To explore the clinical features, diagnosis and treatment points, and causes of misdiagnosis and missed diagnosis of Kounis syndrome. Methods Medical records of one case of type I Kounis syndrome were retrospectively analyzed. Results The elderly patient was hospitalized due to community-acquired pneumonia, and presented delayed anaphylaxis during the anti-infection treatment of Piperacillin Sodium and Tazobactam Sodium. The anti-allergy treatment alleviated the delayed anaphylaxis, but the patient developed symptoms of chest tightness and suffocation. Electrocardiography (ECG) showed a typical pattern of ST elevation in lead Ⅱ, Ⅲ and AVF, with dynamic changes. Myocardial enzyme levels were within the normal ranges. Coronary angiography showed the right coronary artery spasm, which was disappeared after a local injection of nitroglycerin. Conclusion Kounis syndrome is a syndrome of coronary artery spasm secondary to anaphylaxis, which may even cause acute myocardial infarction. It is a rare disorder that causes missed diagnosis and misdiagnosis. Early identification and proper treatment are the key points to improve the clinical prognosis.

Key words: Kounis syndrome, piperacillin, tazobactam drug combination, drug hypersensitivity, coronary vasospasm

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