Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity
Kounis syndrome (KS) is a rare syndrome characterized by the co-occurrence of acute coronary syndromes in the setting of mast cell and platelet activation in response to hypersensitivity reactions. It can be manifested as coronary vasospasms, acute myocardial infarction, or stent thrombosis triggere...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-06-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/58/7/855 |
| _version_ | 1797417156698177536 |
|---|---|
| author | Alberto Navarro-Navajas Ingrid Casallas Daniel Isaza Paola Ortiz Daniela Baracaldo-Santamaría Carlos-Alberto Calderon-Ospina |
| author_facet | Alberto Navarro-Navajas Ingrid Casallas Daniel Isaza Paola Ortiz Daniela Baracaldo-Santamaría Carlos-Alberto Calderon-Ospina |
| author_sort | Alberto Navarro-Navajas |
| collection | DOAJ |
| description | Kounis syndrome (KS) is a rare syndrome characterized by the co-occurrence of acute coronary syndromes in the setting of mast cell and platelet activation in response to hypersensitivity reactions. It can be manifested as coronary vasospasms, acute myocardial infarction, or stent thrombosis triggered by drugs, vaccines, foods, coronary stents, and insect bites. It is a life-threatening condition that needs to be adequately recognized for early diagnosis and appropriate treatment. In this case report, we present a 71-year-old patient with a history of arterial hypertension and non-ST elevation myocardial infarction six months earlier that was treated percutaneously with angioplasty plus stent implantation in the circumflex artery, who subsequently presented to the emergency department due to generalized itching associated with tongue swelling, dyspnea, and chest pain after ingestion of ciprofloxacin for the treatment of a urogenital infection. An electrocardiogram showed ST elevation in II, III, and aVF leads, and positive troponin; thus, a coronary arteriography was performed that showed complete thrombotic stent occlusion in the circumflex artery. Consequently, diagnosis of type 4b inferolateral acute myocardial infarction secondary to ciprofloxacin-triggered type III Kounis syndrome was made. The aim of this report is to understand the relationship between the allergic reaction to ciprofloxacin and the acute coronary syndrome, and to create awareness of the importance of early diagnosis and treatment of this potentially fatal syndrome. |
| first_indexed | 2024-03-09T06:14:46Z |
| format | Article |
| id | doaj.art-7c414c3fdd7e41ac924a347f934a7156 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T06:14:46Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-7c414c3fdd7e41ac924a347f934a71562023-12-03T11:54:21ZengMDPI AGMedicina1010-660X1648-91442022-06-0158785510.3390/medicina58070855Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced HypersensitivityAlberto Navarro-Navajas0Ingrid Casallas1Daniel Isaza2Paola Ortiz3Daniela Baracaldo-Santamaría4Carlos-Alberto Calderon-Ospina5Fundación Cardioinfantil, Bogotá 111221, ColombiaFundación Cardioinfantil, Bogotá 111221, ColombiaFundación Cardioinfantil, Bogotá 111221, ColombiaGrupo Neuros, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, ColombiaPharmacology Unit, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, ColombiaPharmacology Unit, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, ColombiaKounis syndrome (KS) is a rare syndrome characterized by the co-occurrence of acute coronary syndromes in the setting of mast cell and platelet activation in response to hypersensitivity reactions. It can be manifested as coronary vasospasms, acute myocardial infarction, or stent thrombosis triggered by drugs, vaccines, foods, coronary stents, and insect bites. It is a life-threatening condition that needs to be adequately recognized for early diagnosis and appropriate treatment. In this case report, we present a 71-year-old patient with a history of arterial hypertension and non-ST elevation myocardial infarction six months earlier that was treated percutaneously with angioplasty plus stent implantation in the circumflex artery, who subsequently presented to the emergency department due to generalized itching associated with tongue swelling, dyspnea, and chest pain after ingestion of ciprofloxacin for the treatment of a urogenital infection. An electrocardiogram showed ST elevation in II, III, and aVF leads, and positive troponin; thus, a coronary arteriography was performed that showed complete thrombotic stent occlusion in the circumflex artery. Consequently, diagnosis of type 4b inferolateral acute myocardial infarction secondary to ciprofloxacin-triggered type III Kounis syndrome was made. The aim of this report is to understand the relationship between the allergic reaction to ciprofloxacin and the acute coronary syndrome, and to create awareness of the importance of early diagnosis and treatment of this potentially fatal syndrome.https://www.mdpi.com/1648-9144/58/7/855Kounis syndromehypersensitivityacute coronary syndromeciprofloxacinmyocardial infarction |
| spellingShingle | Alberto Navarro-Navajas Ingrid Casallas Daniel Isaza Paola Ortiz Daniela Baracaldo-Santamaría Carlos-Alberto Calderon-Ospina Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity Medicina Kounis syndrome hypersensitivity acute coronary syndrome ciprofloxacin myocardial infarction |
| title | Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity |
| title_full | Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity |
| title_fullStr | Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity |
| title_full_unstemmed | Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity |
| title_short | Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity |
| title_sort | type iii kounis syndrome secondary to ciprofloxacin induced hypersensitivity |
| topic | Kounis syndrome hypersensitivity acute coronary syndrome ciprofloxacin myocardial infarction |
| url | https://www.mdpi.com/1648-9144/58/7/855 |
| work_keys_str_mv | AT albertonavarronavajas typeiiikounissyndromesecondarytociprofloxacininducedhypersensitivity AT ingridcasallas typeiiikounissyndromesecondarytociprofloxacininducedhypersensitivity AT danielisaza typeiiikounissyndromesecondarytociprofloxacininducedhypersensitivity AT paolaortiz typeiiikounissyndromesecondarytociprofloxacininducedhypersensitivity AT danielabaracaldosantamaria typeiiikounissyndromesecondarytociprofloxacininducedhypersensitivity AT carlosalbertocalderonospina typeiiikounissyndromesecondarytociprofloxacininducedhypersensitivity |