title: Kounis syndrome secondary to simultaneous oral amoxicillin and parenteral ampicillin use in a young man.
abstract: The concurrence of acute coronary syndrome with allergy or hypersensitivity as well as with anaphylactic or anaphylactoid reactions is increasingly encountered in daily clinical practice. There are several reports associating mast cell activation with acute cardiovascular events in adults. This was first described by Kounis as 'allergic angina syndrome',progressing to 'allergic myocardial infarction'. The main mechanism proposed is the vasospasm of coronary arteries. We present a case of a 28-year-old man who was admitted to our hospital with thoracic pain and dyspnoea. The symptoms recurred after simultaneous use of 1 g amoxicillin/clavulanic acid orally and 1 g ampicillin/sulbactam parenterally for tonsillitis the night before presentation and on the morning of admission.
authors.affiliation: Cardiology Clinic, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey. bezgintahir3@yahoo.com
authors.forename: Tahir
authors.initials: T
authors.lastname: Bezgin
authors.forename: Çetin
authors.initials: Ç
authors.lastname: Geçmen
authors.forename: Birol
authors.initials: B
authors.lastname: Özkan
authors.forename: Gökhan
authors.initials: G
authors.lastname: Alici
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Kalkan
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kargin
authors.forename: Ali Metin
authors.initials: AM
authors.lastname: Esen
mesh_terms: D054058:Acute Coronary Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D000284:Administration, Oral; D000328:Adult; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000009:adverse effects*; D000667:Ampicillin / Q000008:administration & dosage / Q000009:adverse effects; D000787:Angina Pectoris / Q000139:chemically induced; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D004562:Electrocardiography; D006801:Humans; D007273:Injections, Intramuscular; D007428:Intradermal Tests; D008297:Male; D013407:Sulbactam / Q000008:administration & dosage / Q000009:adverse effects; D014069:Tonsillitis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; C035444:sultamicillin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000667:Ampicillin; D013407:Sulbactam