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Master Thesis

Syndrome de Kounis secondaire aux piqûres d'hyménoptères : critères pour le diagnostic clinique en soins primaires, une revue de la littérature

Abstract : Introduction: primary care doctors are involved in the management of hymenoptera (H) stings. Kounis syndrome (KS) is a serious and under-diagnosed condition. Our aim was to search for clinical diagnostic criteria to improve patient prognosis. Methods: literature review by searching PUBMED from 1950 to June 30, 2020. 22 articles were included. Age, sex, medical history, stingging H., clinical presentation, and severity were reported and summarized. Results: 23 adults with an average age of 51.8 (+/-13) years old were included (12 men). 12 cases were related to bee stings. 5 patients had no cardiovascular risk factors (CVRF) and 13 had low to moderate cardiovascular risk, mainly age and smoking. First symptoms occurred within 15 minutes in 16 cases and KS within 4 hours in 17 patients. Chest pain or related symptom was the manifestation of KS in 19 cases. In the case of syncope, cardiac arrest or shock, the ECG changes was required to make the diagnosis. The most frequent symptoms were: dizziness, blurred vision, pallor, sweating, nausea-vomiting, weakness, in 18 case reports. They were either shortly preceding or concomitant with the cardiac symptoms in 12 patients. Allergic skin signs were absent in 8 cases. Dyspnea was experienced by 8 patients but no author described acute lung oedema. For some, acute coronary syndrome occurred at a distance from the hypersensitivity signs or was the only expression of this reaction. 12 patients experienced serious complications and only one died. Vespid bites were less frequent but appear to be more severe. Conclusion: no clinical criteria could be determined, but it would seem that any cardiovascular sign after a H. sting should lead to the suggestion of KS, even in the absence of allergic skin signs or CVRF. A standardised questionnaire developed from this work could improve the quality of studies in this area.
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Master Thesis
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Submitted on : Monday, May 31, 2021 - 4:13:29 PM
Last modification on : Thursday, July 8, 2021 - 3:16:00 AM


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  • HAL Id : dumas-03243487, version 1



Maylis Galle-Destouet. Syndrome de Kounis secondaire aux piqûres d'hyménoptères : critères pour le diagnostic clinique en soins primaires, une revue de la littérature. Médecine humaine et pathologie. 2021. ⟨dumas-03243487⟩



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