Anaphylactic reaction to streptokinase with first exposure: case report and review of the literature.

Thrombolytic therapy has become an accepted part of the management of acute myocardial infarction. One agent with widespread use in this setting is streptokinase. We report the case of a 62-year-old man who experienced an anaphylactic reaction with cardiopulmonary arrest immediately after receiving streptokinase 1.5 million units iv administered for an acute anterior wall myocardial infarction. The patient had no history of prior exposure to streptokinase, chronic allergic reactions, or reactive airway disease. Five other cases of anaphylaxis to streptokinase are also reviewed.