ArticleJA clinical reports2019
A case of Kounis syndrome presenting as coronary artery spasm associated with cefazolin-induced anaphylaxis during general anesthesia.
Article in JA clinical reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Kounis Syndrome in Cardiac Surgery: Pathophysiology, Antimicrobial Triggers, and Perioperative Recognition and Management.Medical sciences (Basel, Switzerland) · 2026Review
- Turn left or turn right? Lessons from the management of intraoperative cardiac arrest due to Type I Kounis syndrome: a case report.Frontiers in medicine · 2026Article
- A Case of Clinically Suspected Kounis Syndrome Associated with Platelet Transfusion during Thoracoscopic Right Lower Lobectomy.Surgical case reports · 2026Article
- Kounis Syndrome: Review of Clinical Cases.Cardiovascular & hematological disorders drug targets · 2024Review
- Anaphylactic reaction as an etiology of ischemic stroke: A case report.Radiology case reports · 2023Article
- Cardiac Arrest Due to Kounis Syndrome Following Cephazolin Administration During Surgery Under Local Anesthesia.Cureus · 2023Article
- Analysis of Clinical Features of Kounis Syndrome Induced by Cephalosporin.Frontiers in cardiovascular medicine · 2022Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKounis syndrome (KS) is defined as the occurrence of acute coronary syndrome (ACS) associated with an anaphylactic reaction, and there have only been a few reports of its occurrence under general anesthesia. CASE PRESENTATION: A 69-year-old woman underwent transurethral resection of a bladder tumor under general anesthesia. Cefazolin was administered intravenously after induction of general anesthesia. During the operation, we suspected ACS from sudden ST segment depression on electrocardiogram. The delayed onset of an erythematous rash reminded us of the anaphylactic reaction of KS. Coronary artery spasm of type 1 KS was diagnosed based upon the findings of coronary computerized tomography. Eleven days after the first surgery, the patient underwent nephroureterectomy uneventfully by a change in antibiotics. Finally, cefazolin proved to be the trigger drug by the intradermal test.
conclusionWhen electrocardiogram changes suggesting ACS occur during general anesthesia, it is necessary to take KS into consideration as a differential diagnosis.
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