Omar Altermanini, Anas A Ashour, Waleed K Abdullatef, Abdulrahman Arabi, Mhd Baraa Habib
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Kounis syndrome: acute myocardial injury triggered by ant bite-induced anaphylaxis.
Anaphylaxis triggered by insect bites is well-documented, but its association with acute myocardial injury (AMI) is rare. We report a case of Kounis syndrome, where an ant bite induced anaphylaxis and myocardial injury. A 47-year-old diabetic male presented with anaphylaxis following an ant bite, exhibiting hypotension, respiratory distress, and wheezing. Electrocardiography revealed transient widespread ST depression and ST elevation in lead aVR, a pattern reflecting global ischemia, which is uncommon in Kounis syndrome. Treatment with intramuscular adrenaline stabilized his condition. Peak troponin T levels were 1306 ng/l. Coronary angiography and cardiac MRI were unremarkable, ruling out significant coronary artery disease. The patient was diagnosed with Kounis syndrome and discharged with an EpiPen and instructions for anaphylaxis management. This case highlights the potential for ant bites to trigger anaphylaxis-associated myocardial injury, emphasizing the importance of prompt diagnosis and management of Kounis syndrome in similar scenarios.
期刊介绍：
Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialities including cardiology, rheumatology, nephrology, oncology, neurology, and reproduction, comprising a comprehensive resource for physicians in all fields and at all stages of training. Oxford Medical Case Reports deposits all articles in PubMed Central (PMC). Physicians and researchers can find your work through PubMed , helping you reach the widest possible audience. The journal is also indexed in the Web of Science Core Collection . Oxford Medical Case Reports publishes case reports under the following categories: Allergy Audiovestibular medicine Cardiology and cardiovascular systems Critical care medicine Dermatology Emergency medicine Endocrinology and metabolism Gastroenterology and hepatology Geriatrics and gerontology Haematology Immunology Infectious diseases and tropical medicine Medical disorders in pregnancy Medical ophthalmology Nephrology Neurology Oncology Paediatrics Pain Palliative medicine Pharmacology and pharmacy Psychiatry Radiology, nuclear medicine, and medical imaging Respiratory disorders Rheumatology Sexual and reproductive health Sports Medicine Substance abuse.
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