Emergency management of ceftriaxone-induced Type II Kounis syndrome: A case report

Ceftriaxone, a broad-spectrum β-lactam antibiotic, can induce severe allergic reactions such as anaphylaxis, which may lead to life-threatening type II Kounis syndrome (K-S), a variant of acute coronary syndrome triggered by allergic reactions. This case report aims to enhance the clinical understanding of ceftriaxone-induced type II K-S by presenting a detailed account of a patient's emergency management and subsequent recovery, emphasizing the importance of early recognition, intervention, and the role of nursing care in achieving a favorable outcome.

A 73-year-old male with no known allergy history was admitted for cough and shortness of breath. After ceftriaxone administration, he developed chest tightness, shortness of breath, hypotension, and abdominal rash.

Type II K-S triggered by ceftriaxone-induced anaphylaxis was diagnosed.

Immediate management included discontinuing ceftriaxone, emergency tracheal intubation, and intravenous epinephrine. Emergency coronary angiography showed no significant coronary artery stenosis. Postoperatively, the patient received antiplatelet therapy, plaque stabilization, and vasodilation in the intensive care unit.

The patient's condition stabilized, tracheal intubation was removed, and he was discharged after 10 days of treatment with significant clinical improvement.

This case emphasizes the critical importance of early recognition and management of ceftriaxone-induced type II K-S. Vigilant monitoring for allergic reactions and a multidisciplinary approach to care are essential for achieving favorable patient outcomes.