Rifampicin-induced type 1 Kounis syndrome: a rare case

Kounis syndrome (KS) manifests as an acute coronary syndrome triggered by allergy, hypersensitivity, or anaphylaxis. It is believed that mast cells and histamine can potentially induce acute cardiac events by activating various inflammatory pathways. Here, we present a case of KS triggered by rifampicin administered during empyema drainage in a young male patient with no history of coronary artery disease. To the best of our knowledge, our case is the first report of rifampicin-induced KS documented in the literature. The wide range of etiological factors complicates the diagnosis of KS. Healthcare professionals should consider KS as a potential diagnosis in patients experiencing angina or similar pain alongside suspected allergic reactions.