Amoxicillin
- PDF / 152,039 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 51 Downloads / 166 Views
1 S
Amoxicillin Kounis syndrome and cardiac arrest: case report
A 62-year-old man developed type II Kounis syndrome and cardiac arrest following administration of amoxicillin during dentistry intervention. The man presented with general asthenia to the emergency department. He had concurrent conditions including hypertension, dyslipidaemia and diabetes mellitus. He had a previous history of smoking and allergy from non-steroidal anti-inflammatories and penicillins. Five months before the current presentation, he had experienced face erythema following pre-operative administration of amoxicillin for dentistry intervention. Soon after the current presentation, he developed cardiac arrest. The man underwent supportive treatment with adrenaline due to the occurrence of asystolia. His cardiac rhythm recovered; however, gasping, miosis, coma and mucocutaneous cyanosis persisted. He was tachycardiac with HR of 130.beats per minute and BP of 130/80mm.Hg. Hypercapnic hypoxia and metabolic acidosis were revealed with arterial blood gas analysis. Therefore, mechanical ventilation and orotracheal intubation were performed along with administration of bicarbonate. An increase in WBC and mild augmentation of high-sensitivity troponin levels were revealed in the biochemical analysis. Signs of pulmonary emphysema and sinusopathy were seen in the cranial and thoracic CT scan. ECG demonstrated ST-segment elevation in the inferior leads, with specular anterior ST-segment depression. Transthoracic echocardiography (TTE) indicated hypertensive heart disease. Long, subcritic (70%) stenosis at medium tract of the left anterior descending artery (LAD); long, subcritic (60%) stenosis at the proximal-medium tract of the first diagonal artery; short, critic (95%) stenosis at the distal tract of the posterior descending artery (PDA) were observed within emergency coronary angiography. The man was transferred to the department of anaesthesia and intensive care medicine. The invasive ventilation was weaned off the day after the index event. He reported that his symptoms occurred after the intake of oral amoxicillin 500mg for the dental care prophylaxis. He was discharged after about one week of admission. He showed HR between 56 and 112.beats per minute, 24h ECG Holter outlined sinus rhythm, rare ventricular, monomorphic, nonrepetitive, ventricular extrasystoles and rare supraventricular extrasystoles at the 30.day follow up. Ischaemic alterations were still present. Similar results were obtained at 3.months follow up. Caragnano V, et al. Cardiac arrest in type ii kounis syndrome after oral intake of amoxicilline. American Journal of Cardiovascular Disease 10: 195-200, No. 3, Jan 2020
0114-9954/20/1824-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
803504387
Reactions 3 Oct 2020 No. 1824
Data Loading...
