Kounis syndrome due to hirudotherapy (leech therapy) in emergency department; a case report

Tolga Çakmak; İbrahim Çaltekin; Emre Gökçen; Atakan Savrun; Erdoğan Yaşar

doi:10.1016/j.tjem.2017.12.005

Tolga Çakmak¹, İbrahim Çaltekin², Emre Gökçen³, Atakan Savrun⁴, Erdoğan Yaşar¹

¹Department of Cardiology, Malatya Training and Research Hospital, Malatya, Turkey
²Department of Emergency Medicine, Bozok University Faculty of Medicine, Yozgat, Turkey
³Department of Emergency Medicine, Malatya Training and Research Hospital, Malatya, Turkey
⁴Department of Emergency Medicine, Ordu University Faculty of Medicine, Ordu, Turkey

Keywords: Acute coronary syndrome; Emergency medicine; Leech therapy

Abstract

Kounis Syndrome is the development of acute coronary syndrome (ACS) because of allergic reactions; allergens, such as foods, insect venom, iodine contrast agent or drugs can cause this syndrome. Hirudotherapy (leech therapy) is increasingly used as a useful therapeutic option in a variety of medical and surgical procedures, and potential complications related to this therapy include Aeromonas species infections, bleeding, anemia and allergic reactions. Here, we present a patient diagnosed as Type 1 Kounis Syndrome after using hirudotherapy for her knee aches. 41-year-old woman admitted to emergency department with sudden onset of face edema, shortness of breath and chest pain complaints and diagnosed as an allergic reaction and anaphylaxis due to leech therapy. Kounis Syndrome should be considered in acute coronary syndrome patients who were admitted to emergency department with anaphylaxis clinic.