Abstract
Kounis Syndrome is a rare allergic reaction that results in coronary vasospasm and
may occur in patients with and without coronary artery disease. A 57-year-old man
receiving pre-operative vancomycin for osteomyelitis and gangrene of the foot experienced
an episode of anginal symptoms associated with transient ischemic 12-lead electrocardiogram
(ECG) changes. The patient's symptoms and ECG changes abated with discontinuation
of vancomycin and subsequent coronary angiography revealed no evidence of coronary
artery disease. Treatment of Kounis Syndrome begins with cessation of the causative
agent. Consensus guidelines for the management of Kounis Syndrome have not been established
but treatment should both dilate the coronary vessels and suppress the allergic response.
Coronary vasospasm after administration of antibiotics, including vancomycin, is a
rare but serious reaction. It is important that Emergency Physicians recognize Kounis
Syndrome as an uncommon yet dramatic and consequential reaction to such a commonly-administered
antibiotic.
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Article Info
Publication History
Published online: June 03, 2019
Accepted:
June 1,
2019
Received in revised form:
May 30,
2019
Received:
May 17,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
