# A Report of a Rare Case of Kounis Syndrome in a Patient With HIV/AIDS and Mpox

## TL;DR

A rare case of Kounis Syndrome is reported in a man with HIV/AIDS and mpox, triggered by vancomycin and resulting in a heart attack.

## Contribution

This case report highlights a rare occurrence of Kounis Syndrome in a patient with HIV/AIDS and mpox, triggered by vancomycin.

## Key findings

- A 45-year-old man with HIV/AIDS and mpox developed STEMI during vancomycin infusion.
- Discontinuing vancomycin resolved ECG changes and symptoms, with normal coronary arteries on catheterization.

## Abstract

Kounis syndrome (KS) is defined as the occurrence of acute coronary syndrome due to coronary artery spasm in a patient with an allergic reaction. Antibiotics are the most common trigger for KS. In this case report, we present a 45-year-old man with HIV/AIDS who was being managed for mpox and developed chest pain and hypotension during vancomycin infusion, which was complicated by the development of ST-elevation myocardial infarction (STEMI). His left heart catheterization showed normal coronaries with the resolution of ECG changes and symptoms upon discontinuing vancomycin.