Thrombo-embolic complication after streptokinase therapy of pulmonary emboli.

A 58-year old patient is reported who developed an ischaemic cerebrovascular accident 22 hours after successful thrombolysis with streptokinase for life-threatening pulmonary emboli. Despite effective thrombolysis, the plasma fibrinogen level rose during streptokinase administration and reached extremely high values 72 hours later. The mechanism of this unusual early and extreme rise of fibrinogen levels is unclear but it probably played a role in the pathogenesis of the cerebrovascular accident.