Kounis syndrome associated with Moxifloxacin infusion in a patient with COVID-19 pneumonia: a case report

• Authors: Ivan Tverdokhlib , Oleksiy Skakun , Sergiy Fedorov , Olga Verbovska , Irena Kozlova , Ilona Martyniv

Abstracts

EN

Kounis syndrome (KS) is an acute coronary syndrome developing as a consequence of an anaphylactic or allergic reaction. Multiple mediators (especially histamine) released by mast cells, platelets, and some immune cells may lead to coronary vasospasm or thrombosis and cause an acute coronary syndrome. A clinical case of the KS in a hospitalized patient being treated for the COVID-19-associated pneumonia is presented. A 62-year-old woman was treated for COVID-19-associated pneumonia. In 15 min after the beginning of the Moxifloxacin infusion, the patient complained of severe headache, crushing chest pain, abdominal pain, severe general weakness, shortness of breath. Hypotension and decrease in SpO2 developed. Immediately performed ECG showed the ST-segment elevation in leads I and aVL. There were reciprocal changes in leads III, aVF, V3-V6. Troponin I was slightly elevated. Coronary angiography showed no hemodynamically significant coronary artery lesions. The KS type 1 was diagnosed. Repeated ECG in 2 hours showed isoelectric ST segments in all leads. It may be difficult to diagnose KS. Clinical signs of an allergic or anaphylactic reaction should raise the suspicion of KS. Moxifloxacin as well as other fluoroquinolones may be associated with the development of KS. We suggest a possible association of COVID-19 with KS. However, this issue requires further observation.

Keywords

EN

Kounis syndrome; acute coronary syndrome; COVID-19; coronary vasospasm; case report

• Publisher: Towarzystwo Pomocy Doraźnej
• Journal: Critical Care Innovations
• Year: 2021
• Volume: 4
• Issue: 2
• Pages: 32-37

Dates

published

2021

Contributors

author

Ivan Tverdokhlib

author

Oleksiy Skakun

author

Sergiy Fedorov

author

Olga Verbovska

author

Irena Kozlova

author

Ilona Martyniv

References

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Identifiers

DOI

10.32114/CCI.2021.4.2.32.37

Biblioteka Nauki

29432072