Anaphylaxis and Kounis syndrome after using amoxicillin and clavulanic acid

Introduction: Kounis syndrome is the fortuitous occurrence of acute coronary syndrome consisting of hypersensitivity reactions related to allergic or hypersensitivity activation of inflammatory cells. Case Report: An 84-yearold male admitted to our emergency department with anaphylaxis symptoms after his intake of a 1000 mg amoxicillin and clavulanic acid (ACA) tablet. Diabetes, coronary artery disease and hypertension had been encountered in the patient's medical history. During the physical examination, uvula edema, wheezing, rales and rhonchi were present. Adrenaline, pheniramine and methylprednisolone were given to the patient with a diagnosis of anaphylaxis. During his observation, ECG changes and troponin elevation were detected and he was diagnosed as type 2 Kounis syndrome. After 24 hours followup, he was discharged without any complication. Conclusion: A single dose of ACA can cause anaphylaxis and may result in Kounis syndrome. It should be taken into consideration in all types of allergic reactions which treated by adrenaline.