Kounis Syndrome Following Beta-Lactam Antibiotic Use: Review of Literature

Ridella, Maricel; Bagdure, Satish; Nugent, Kenneth; Çevik, Cihan

doi:10.2174/187152809787582462

Cited by 68 publications

(61 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hypersensitivity reactions following implantation of drug-eluting stents and stent thrombosis which may be considered as a manifestation of Kounis syndrome, a type III variant of Kounis syndrome has been introduced [5,6]. Drugs implicated with Kounis syndrome include catecholamines (epinephrine, norepinephrine, isoproterenol, dopamine, dobutamine); parasympathomimetic agents (acetylcholine, methacholine, pilocarpine); anticholinesterase agents (neostigmine); beta-blockers; anaesthetic agents (etomidate); antibiotics (ciprofloxacin, amoxicillin, ampicillin, cephalosporins, vancomycin); NSAIDS; chemotherapeutic drugs; thrombolytic agents; withdrawal from chronic exposure to nitroglycerine, cocaine, smoking and alcohol [7][8][9][10]. No biomarker accurately predicts the risk of Kounis syndrome, albeit recent reports link elevated serum tryptase levels to increased susceptibility to allergic reactions as well as asymptomatic ACS.…”

Section: Discussionmentioning

confidence: 99%

Type 1 Kounis Syndrome Triggered by Noradrenaline in a case of Pyogenic Meningitis

J¹,

Rahman²,

N³

et al. 2016

JCR

View full text Add to dashboard Cite

Abstract:Kounis syndrome is the coincidental occurrence of acute coronary syndromes with allergic or hypersensitivity reactions. Kounis syndrome has been established as a hypersensitivity coronary disorder induced by various conditions, drugs, environmental exposures, food items and drug eluting coronary stents. It is not a rare disease but an infrequently diagnosed clinical entity. Clinicians should be aware that various mediators of allergy can cause coronary spasm and even plaque rupture and thrombus formation, thereby causing a serious impact on the course, prognosis and management of the allergic reaction. Here we report a rare case of Type 1 Kounis syndrome triggered by nordrenaline in a patient with pyogenic meningitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Type 1 Kounis Syndrome Triggered by Noradrenaline in a case of Pyogenic Meningitis

J¹,

Rahman²,

N³

et al. 2016

JCR

View full text Add to dashboard Cite

show abstract

“…13 Hundreds of cases of Kounis syndrome have been described since, including several case series. [32][33][34][35] Kounis syndrome has been described secondary to a large number of drugs, of various classes (e.g. antibiotics, muscle relaxants, anti-neoplastics, contrast media, NSAIDS, thrombolytics etc.).…”

Section: Aetiologymentioning

confidence: 99%

Kounis syndrome: a narrative review

Fourie

2016

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

Inflammatory mediators released from activated mast cells and basophils during hypersensitivity reactions have direct pathological effects on the myocardium and coronary vasculature. It was traditionally thought that cardiovascular signs and symptoms in anaphylaxis are largely due to peripheral vasodilation and increased vascular permeability. However, there is extensive evidence of primary cardiac involvement during hypersensitivity reactions, most notably coronary vasoconstriction as well as atherosclerotic plaque erosion and rupture, leading to angina pectoris and acute coronary syndromes. Furthermore, mast cells are well established as effector cells in atherosclerosis, through their effects on atherosclerotic plaque progression and destabilisation. It was noted over 30 years ago that cardiac patients have a markedly higher concentration of biologic amines (especially histamine) in their coronary vasculature, and, additionally, are hyper-reactive to the effects thereof. This is borne out by the disproportionate mortality rate of those with cardiac disease that suffer a hypersensitivity reaction. Kounis syndrome refers to angina pectoris or an acute coronary syndrome secondary to a hypersensitivity reaction, with the subtypes dependent on the underlying state of the coronaries and presence of a drug-eluting stent or not. This review will focus mainly on the aetiology, pathophysiology, diagnoses and treatment of this important syndrome.

show abstract

“…Actually in literature more than 30 cases of KS betalactamsinduced have been reported [4] and amoxicillin is the most frequently involved molecule, followed by Ampicillin, Penicillin G and various cephalosporins, but no case of KS due to piperacillin/tazobactam infusion have been never previously reported.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%