Key result
Vancomycin linked to reversible type I Kounis syndrome mimicking inferior-lateral MI.
Why the study?
Kounis syndrome is a relatively rare phenomenon characterized by acute coronary syndrome triggered by an allergic reaction, with limited case descriptions involving vancomycin.
Case Report (n=1)
Vancomycin can trigger type I Kounis syndrome, presenting as acute coronary syndrome that resolves upon withdrawal of the offending drug.
May warrant vigilance for Kounis syndrome during vancomycin reactions; single case leaves open incidence, causality, and management.
Kounis syndrome defined as the appearance of acute coronary syndrome in the context of an allergic reaction is a relatively rare phenomenon. There are three variants of this syndrome in which the patient presents with symptoms of an acute chest. Herein, we describe a case of an 83-year-old woman who demonstrated type I variant of Kounis syndrome in response to vancomycin administration. After initialisation of vancomycin, she became unresponsive and an ECG demonstrated ST changes consistent with inferior-lateral myocardial infarction. Once allergic stimulus was removed, ECG normalised. Differential diagnosis includes, myocardial infarctions, angina as well as intravascular stent thrombosis, which must all be ruled out. The patient was monitored and discharged soon thereafter.
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Martínez et al. (2018) conducted a case report in Kounis syndrome (n=1). Vancomycin was evaluated on Coronary artery spasm / Kounis syndrome. Vancomycin administration induced a type I variant of Kounis syndrome, presenting with ECG changes consistent with inferior-lateral myocardial infarction that normalized upon removal of the stimulus.
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