Introduction

Streptokinase is a widely used fibrinolytic agent for treating cardiovascular diseases, particularly in developing countries due to its cost-effectiveness1. Isolated from hemolytic streptococci, Streptokinase forms complexes with plasminogen to activate it into plasmin, which then dissolves blood clots and helps in improving reperfusion and left ventricular function in different cardiovascular diseases2. Being derived from bacterial protein, it can result in allergic reactions and bleeding, which are common adverse events. Patients might also have bradycardia and hypotension, along with fever, shivering, and rashes, as well as anaphylactic reactions3. Few case reports have reported serum sickness as a complication of Streptokinase therapy. Alexopoulos et al. (1984) have reported serum sickness as a complication of intravenous streptokinase when used for acute myocardial infaraction4. Serum Sickness is a Type III immune complex mediated hypersensitivity reaction which was first recognized in a patient who received heterologous antisera in the early 1990s. The symptoms usually occur after 1 to 2 weeks after exposure to offending agents and is a self-limited disease5. Although the condition is self-limiting, severe cases may require intervention. Treatment often involves discontinuing the offending agent and administering corticosteroids, which can lead to complete recovery6. In this we report a rare case from Tertiary Teaching Hospital of a 36-year-old female, with a known history of mitral valve stenosis secondary to Rheumatic Heart Disease who underwent Streptokinase treatment and presenting with Serum Sickness. This case underscores the complexities of managing prosthetic valve thrombosis and highlights the importance of monitoring and addressing potential complication of thrombolytic therapy.