Amoxicillin

Abstract

S Amoxicillin Kounis syndrome: case reportA 41-year-old man developed Kounis syndrome following treatment with amoxicillin [dosage and indication not stated].The man presented with pruritus and redness of skin after amoxicillin intake. The minutes after the skin symptoms began, he had chest pain, which gradually worsened. At presentation, his heart rate was 87/minute, respiratory rate was 16/minute, BP was 135/90 mmHg. His physical examination showed acute urticarial plaques with a tendency to coalesce. His ECG within 10 minutes of presentation, showed ST elevation in inferior derivations.The man received aspirin, heparin, methylprednisolone, pheniramine and ranitidine. His coronary angiogram showed minor coronary artery disease with luminal irregularities in all coronary arteries. The cardiac enzymes at 8 and 12 hours after the start of chest pain were 0.071 ng/mL and 0.108 ng/mL, respectively. He was discharged without recurrent symptoms. Later, his echo-cardiogram revealed normal left ventricular function with an ejection fraction of 58%. He continued antihistaminic therapy along with aspirin therapy. His skin prick test with extracts of airborne and food allergens failed to show any offending agent; however, he remained free of symptoms.Author comment: "A 41-year-old male patient presented to our emergency department with pruritus and redness of skin after taking amoxicillin. He simultaneously had substernal chest pain." Ciftci O, et al. An unusual presentation of allergic reactions: Kounis syndrome.