Kounis Syndrome: A Case of Vancomycin-Associated Coronary Artery Vasospasm Resulting in Myocardial Infarction

We describe a case of Kounis syndrome, an allergic reaction causing coronary artery vasospasm, triggered by a vancomycin infusion, in a healthy 32-year-old man. The patient initially presented with an inguinal abscess requiring intravenous vancomycin. During his third infusion, he developed typical chest pain that resolved with cessation of the infusion. Troponin was elevated, and electrocardiogram showed ST elevation, prompting emergent cardiac catheterization that demonstrated normal coronary arteries. The cause of the myocardial infarction was consistent with Kounis syndrome. Diagnosis of Kounis syndrome is important, as prompt cessation of the offending agent is a priority to reduce further cardiac injury.