title: Kounis syndrome secondary to intravenous cephalosporin administration.
abstract: Kounis syndrome is a clinical condition due to hypersensitivity that culminates into acute coronary syndrome (ACS) which can be fatal. A 36-year-old male with no conventional coronary risk factors presented elsewhere with a history of fever for 4 days, cough with expectoration, diarrhea and was treated with cephalosporin (Inj. Cefotaxime as an infusion) along with analgesics. He experienced generalized itching 5 minutes after cefotaxime infusion followed by sweating, headache, chest pain with facial and periorbital swelling for which he was rushed to our hospital. On examination he was afebrile with a low blood pressure. Electrocardiogram taken at an outside hospital revealed incomplete right bundle branch block and ST depression V3-V5. Investigations showed increase in troponin T. He was managed with anti-histamines and standard protocol for treatment of ACS. Coronary angiogram revealed normal coronaries. The patient improved symptomatically with treatment and was discharged on an anti-platelet, nitrate and a statin.
authors.affiliation: Department of Pharmacy Practice, PSG College of Pharmacy, Coimbatore, Tamil Nadu, India.
authors.forename: Sunkavalli
authors.initials: S
authors.lastname: Venkateswararao
authors.affiliation: Department of Cardiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
authors.forename: Gopalan
authors.initials: G
authors.lastname: Rajendiran
authors.affiliation: Department of Cardiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
authors.forename: Rathakrishnan Shanmuga
authors.initials: RS
authors.lastname: Sundaram
authors.affiliation: Department of Pharmacy Practice, PSG College of Pharmacy, Coimbatore, Tamil Nadu, India.
authors.forename: Godavarthi
authors.initials: G
authors.lastname: Mounika
keywords: Acute coronary syndrome; Kounis syndrome; cephalosporin; hypersensitivity
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