The mechanisms underlying allergic reactions to streptokinase treatment can be divided into three major groups: immediate IgE mediated (type I), immune complex deposition (type III), and antiorgan antibody mediated (type II). Apart from cerebral haemorrhage the only previously reported neurological complication of streptokinase therapy is the Guillan-Barré syndrome.1 We present a case of meningoencephalitis after streptokinase therapy.

A 52 year old man presented with classic features of an acute anterior myocardial infarction. Treatment with oral aspirin and intravenous streptokinase was initiated. Fifteen minutes later he developed a diffuse erythematous skin rash, pyrexia of 39^oC, a tender, swollen throat, and became hypotensive. The streptokinase infusion was discontinued and intravenous hydrocortisone and chlorpheniramine were administered. His symptoms settled within 24 hours. He made an uncomplicated recovery and …