Kounis syndrome. Apropos of a clinical case

Clinical features, diagnosis and management of amoxicillin-induced Kounis syndrome

“…Of the remaining 79 studies, 48 were excluded from the full-text review. A total of 31 studies were included ( Alemparte Pardavila et al, 1999 ; López-Abad et al, 2004 ; Moreno-Ancillo et al, 2004 ; Gikas et al, 2005 ; Del Furia et al, 2007 ; Tigen et al, 2007 ; Tavil et al, 2008 ; Vivas et al, 2008 ; Biteker et al, 2009 ; Caglar et al, 2011 ; Venturini et al, 2011 ; Viana-Tejedor et al, 2011 ; Mazarakis et al, 2012 ; Bezgin et al, 2013 ; Calf et al, 2013 ; Ilhan et al, 2013 ; Kilickesmez et al, 2013 ; Lombardi et al, 2013 ; González-de-Olano et al, 2014 ; Ralapanawa and Kularatne, 2015 ; Molina Anguita et al, 2016 ; Salouage et al, 2016 ; Shimi et al, 2016 ; Antonelli et al, 2017 ; Canpolat et al, 2017 ; Omri et al, 2017 ; Pradhan et al, 2018 ; Lopes and Agarwal, 2019 ; Moloney et al, 2019 ; Caragnano et al, 2020 ; Duarte et al, 2020 ). The basic information of these 33 patients is summarized in Table 1 .…”

“…Eight patients (24.2%) had a history of smoking habits ( Vivas et al, 2008 ; Venturini et al, 2011 ; Mazarakis et al, 2012 ; Lombardi et al, 2013 ; Salouage et al, 2016 ; Pradhan et al, 2018 ; Caragnano et al, 2020 ). Four patients (12.1%) had previous history of penicillin-allergy ( Antonelli et al, 2017 ; Omri et al, 2017 ; Caragnano et al, 2020 ; Duarte et al, 2020 ). Five patients (15.2%) were treated with other drugs concurrently.…”

“…The main clinical manifestations of these patients included chest pain in 21 patients (63.6%), allergic reactions (rash, pruritus, erythema) in 25 patients (75.8%), neurological adverse reactions (alteration of consciousness, dizziness) in 10 patients (30.3%), and gastrointestinal adverse reactions (nausea, vomiting, abdominal pain) in 10 patients (30.3%), dyspnea in 6 patients (18.2%), swelling (lips, hands, tongue, face) in 2 patients (6.1%). Thirteen patients had hypotension at the onset of symptoms ( Alemparte Pardavila et al, 1999 ; López-Abad et al, 2004 ; Gikas et al, 2005 ; Vivas et al, 2008 ; Mazarakis et al, 2012 ; Kilickesmez et al, 2013 ; Lombardi et al, 2013 ; González-de-Olano et al, 2014 ; Ralapanawa and Kularatne, 2015 ; Salouage et al, 2016 ; Shimi et al, 2016 ; Duarte et al, 2020 ). Cardiac arrest occurred in 4 patients (12.1%) ( Calf et al, 2013 ; Canpolat et al, 2017 ; Caragnano et al, 2020 ; Duarte et al, 2020 ).…”

“…Thirteen patients had hypotension at the onset of symptoms ( Alemparte Pardavila et al, 1999 ; López-Abad et al, 2004 ; Gikas et al, 2005 ; Vivas et al, 2008 ; Mazarakis et al, 2012 ; Kilickesmez et al, 2013 ; Lombardi et al, 2013 ; González-de-Olano et al, 2014 ; Ralapanawa and Kularatne, 2015 ; Salouage et al, 2016 ; Shimi et al, 2016 ; Duarte et al, 2020 ). Cardiac arrest occurred in 4 patients (12.1%) ( Calf et al, 2013 ; Canpolat et al, 2017 ; Caragnano et al, 2020 ; Duarte et al, 2020 ).…”

“…Nine patients (27.3%) reported elevated creatine kinase-myocardial band (CK-MB) (Moreno-Ancillo et al, 2004;Gikas et al, 2005;Tigen et al, 2007;Tavil et al, 2008;Biteker et al, 2009;Venturini et al, 2011;Bezgin et al, 2013;Kilickesmez et al, 2013;Omri et al, 2017). The serum tryptase levels were significantly elevated in 5 patients (15.2%) undergoing examination (Biteker et al, 2009;González-de-Olano et al, 2014;Molina Anguita et al, 2016;Lopes and Agarwal, 2019;Duarte et al, 2020). The results were positive in 10 patients (30.3%) undergoing skin prick tests (Alemparte Pardavila et al, 1999;López-Abad et al, 2004;Moreno-Ancillo et al, 2004;Gikas et al, 2005;Del Furia et al, 2007;Vivas et al, 2008;Bezgin et al, 2013;Kilickesmez et al, 2013;González-de-Olano et al, 2014;Molina Anguita et al, 2016).…”