Fatal pediatric case of Kounis syndrome and sepsis: a case report

Abstract Background Kounis syndrome is a hypersensitivity reaction that induces acute coronary artery events, nevertheless its pediatric occurrence remains rare and often underdiagnosed. This report describes a fatal case of Kounis syndrome triggered by ceftriaxone-lidocaine administration in a chil...

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Main Authors: Tamara Berezna, Olha Synoverska, Nadiya Fomenko, Iryna Pylyuk, Khrystyna Lazurkevych, Viktoria Bedei, Taras Kotyk
Format: Article
Language:English
Published: BMC 2025-05-01
Series:International Journal of Emergency Medicine
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Online Access:https://doi.org/10.1186/s12245-025-00886-4
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author Tamara Berezna
Olha Synoverska
Nadiya Fomenko
Iryna Pylyuk
Khrystyna Lazurkevych
Viktoria Bedei
Taras Kotyk
author_facet Tamara Berezna
Olha Synoverska
Nadiya Fomenko
Iryna Pylyuk
Khrystyna Lazurkevych
Viktoria Bedei
Taras Kotyk
author_sort Tamara Berezna
collection DOAJ
description Abstract Background Kounis syndrome is a hypersensitivity reaction that induces acute coronary artery events, nevertheless its pediatric occurrence remains rare and often underdiagnosed. This report describes a fatal case of Kounis syndrome triggered by ceftriaxone-lidocaine administration in a child, in the context of sepsis and multiple organ dysfunction syndrome. Case presentation A 4-year girl with a history of cyclic vomiting syndrome, was admitted to the ICU with severe lethargy and pallor 30 min after the second intramuscular injection of ceftriaxone, which had been prescribed for vomiting, diarrhea, and fever. Her laboratories were pertinent for a metabolic acidosis, neutrophilic leukocytosis, renal dysfunction, elevated cardiac markers (troponin I and cardiac-type creatine phosphokinase), EKG signs of myocardial ischemia, bilateral bronchopneumonia, and right lower multifocal pneumonia. Despite intensive management, the patient’s condition continued to deteriorated, which lead to multiple organ dysfunction and eventual death. Conclusion This case highlights the need for heightened clinical awareness of Kounis syndrome in pediatric settings, especially in patients with underlying infections. This case underscores the fatal potential of undiagnosed Kounis syndrome in the pediatric population and highlights the urgent need for enhanced vigilance and multidisciplinary preparedness.
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spelling doaj-art-d8500da16e9c4a0ab32692e1aaaf36a72025-08-20T02:10:48ZengBMCInternational Journal of Emergency Medicine1865-13802025-05-011811710.1186/s12245-025-00886-4Fatal pediatric case of Kounis syndrome and sepsis: a case reportTamara Berezna0Olha Synoverska1Nadiya Fomenko2Iryna Pylyuk3Khrystyna Lazurkevych4Viktoria Bedei5Taras Kotyk6Department of Children’s Diseases of Postgraduate Education, Ivano-Frankivsk National Medical UniversityDepartment of Children’s Diseases of Postgraduate Education, Ivano-Frankivsk National Medical UniversityDepartment of Children’s Diseases of Postgraduate Education, Ivano-Frankivsk National Medical UniversityDepartment of Children’s Diseases of Postgraduate Education, Ivano-Frankivsk National Medical UniversityDepartment of Children’s Diseases of Postgraduate Education, Ivano-Frankivsk National Medical UniversityDivision of Pulmonology, Center of Infection DiseasesDepartment of Human Anatomy, Ivano-Frankivsk National Medical UniversityAbstract Background Kounis syndrome is a hypersensitivity reaction that induces acute coronary artery events, nevertheless its pediatric occurrence remains rare and often underdiagnosed. This report describes a fatal case of Kounis syndrome triggered by ceftriaxone-lidocaine administration in a child, in the context of sepsis and multiple organ dysfunction syndrome. Case presentation A 4-year girl with a history of cyclic vomiting syndrome, was admitted to the ICU with severe lethargy and pallor 30 min after the second intramuscular injection of ceftriaxone, which had been prescribed for vomiting, diarrhea, and fever. Her laboratories were pertinent for a metabolic acidosis, neutrophilic leukocytosis, renal dysfunction, elevated cardiac markers (troponin I and cardiac-type creatine phosphokinase), EKG signs of myocardial ischemia, bilateral bronchopneumonia, and right lower multifocal pneumonia. Despite intensive management, the patient’s condition continued to deteriorated, which lead to multiple organ dysfunction and eventual death. Conclusion This case highlights the need for heightened clinical awareness of Kounis syndrome in pediatric settings, especially in patients with underlying infections. This case underscores the fatal potential of undiagnosed Kounis syndrome in the pediatric population and highlights the urgent need for enhanced vigilance and multidisciplinary preparedness.https://doi.org/10.1186/s12245-025-00886-4Case reportChildrenKounis syndromeSepsis
spellingShingle Tamara Berezna
Olha Synoverska
Nadiya Fomenko
Iryna Pylyuk
Khrystyna Lazurkevych
Viktoria Bedei
Taras Kotyk
Fatal pediatric case of Kounis syndrome and sepsis: a case report
International Journal of Emergency Medicine
Case report
Children
Kounis syndrome
Sepsis
title Fatal pediatric case of Kounis syndrome and sepsis: a case report
title_full Fatal pediatric case of Kounis syndrome and sepsis: a case report
title_fullStr Fatal pediatric case of Kounis syndrome and sepsis: a case report
title_full_unstemmed Fatal pediatric case of Kounis syndrome and sepsis: a case report
title_short Fatal pediatric case of Kounis syndrome and sepsis: a case report
title_sort fatal pediatric case of kounis syndrome and sepsis a case report
topic Case report
Children
Kounis syndrome
Sepsis
url https://doi.org/10.1186/s12245-025-00886-4
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AT irynapylyuk fatalpediatriccaseofkounissyndromeandsepsisacasereport
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