RESUMEN
Kounis syndrome, also known as allergic myocardial infarction or allergic angina syndrome, coincides with chest pain and allergic reactions. It involves the activation of interrelated inflammatory cells following allergic, anaphylactic or anaphylactoid insults. We report a case of Kounis syndrome complicated by an injection of ceftazidime. A 52-year-old man developed shortness of breath and hypotension, leading to immediate unconsciousness, after a ceftazidime injection. Despite intensive care management, he showed no improvement and died approximately 19 h after ceftazidime administration. Autopsy showed massive laryngeal oedema, mucous plugging and collapsed lungs. An ImmunoCAP tryptase assay showed the tryptase level in an autopsy sample to be 118 µg/L (normal < 11.4 µg/L). Microscopy of the myocardium showed cellular infiltration preceding myocardial necrosis. These findings support the pathophysiological theory of Kounis syndrome, with cellular infiltration proposed as the cause of myocardial injury rather than an effect related to the healing process.
Asunto(s)
Ceftazidima/efectos adversos , Síndrome de Kounis/complicaciones , Síndrome de Kounis/etiología , Antibacterianos/efectos adversos , Antibacterianos/uso terapéutico , Autopsia , Ceftazidima/uso terapéutico , Humanos , Síndrome de Kounis/fisiopatología , Masculino , Persona de Mediana Edad , Infarto del Miocardio/etiología , Infarto del Miocardio/mortalidad , Punciones/efectos adversosRESUMEN
Forensic pathologists are often expected to provide an opinion on the intention of the assailant in sharp force fatalities. A retrospective study was carried out on reports of post-mortems of victims of sharp force trauma over five years. The position and type of injuries were recorded and related to the known motivation for murder. Victims of different motives of killing had an almost similar injury pattern. There is no significant association of the pathology of sharp force injuries with the motive of killing.