DOI: 10.363247/sjmcr.2018.v06i10.027

Pages: 840-842

A seventy-one-year-old woman was administered ceftriaxone for pyelonephritis. The patient suddenly complained of breathing difficulty and electrocardiography (ECG) revealed pulseless electrical activity and ST segment elevation. Her initial rhythm, when she was transported to our department, was asystole. A return of spontaneous circulation was obtained after the administration of adrenaline. She was diagnosed with anaphylaxis with shock and Kounis syndrome. This is the fourth case and the first fatal case of Kounis syndrome induced by ceftriaxone. The therapeutic management of Kounis syndrome is challenging as it aims for myocardial revascularization as well as the treatment of the concomitant allergic reaction.