Serum sickness: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
*Primary occurs 6-21 days after exposure | |||
**1-4 days after subsequent exposures to the same antigen | |||
*Fever | |||
*Arthralgia | |||
*Lymphadenopathy | |||
*Skin eruption (rash) | |||
**Urticaria | |||
**Scarlatiniform rash | |||
**Maculopapular or purpuric lesions | |||
**Erythema multiforme | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* [[Erythema multiforme]] | |||
* [[Mononucleosis]] | |||
* [[Polymyositis]] | |||
* [[Systemic Lupus Erythematosus]] | |||
* Tick-Borne Diseases, [[Rocky Mountain Spotted Fever]] | |||
* [[Toxic Epidermal Necrolysis]] | |||
{{Differential Diagnosis Polyarthritis}} | |||
==Treatment== | ==Treatment== | ||
*D/C antigen | |||
*Diphenhydramamine | |||
*Prednisone | |||
==Disposition== | ==Disposition== | ||
Admit for: | Admit for: | ||
*Significant comorbidities (advanced or very young age, immunocompromised) | |||
*Severe symptoms | |||
*Hemodynamic instability/hypotension | |||
*Unclear diagnosis | |||
==Prognosis== | ==Prognosis== | ||
*Symptoms usually last 1-2 weeks before spontaneously subsiding | |||
*Long-lasting sequelae generally do not occur | |||
*Fatalities are rare and usually are due to continued administration of the antigen | |||
[[Category:Derm]] | [[Category:Derm]] | ||
Revision as of 06:23, 30 July 2015
Background
- A type III hypersensitivity reaction
- Secondary to injection of anitoxins (e.g. tetanus, rabies)
- Reactions secondary to the administration of nonprotein drugs
- Amoxicillin, cefaclor, cephalexin (Keflex), trimethoprim-sulfamethoxazole
Diagnosis
- Primary occurs 6-21 days after exposure
- 1-4 days after subsequent exposures to the same antigen
- Fever
- Arthralgia
- Lymphadenopathy
- Skin eruption (rash)
- Urticaria
- Scarlatiniform rash
- Maculopapular or purpuric lesions
- Erythema multiforme
Differential Diagnosis
- Erythema multiforme
- Mononucleosis
- Polymyositis
- Systemic Lupus Erythematosus
- Tick-Borne Diseases, Rocky Mountain Spotted Fever
- Toxic Epidermal Necrolysis
Polyarthritis
- Fibromyalgia
- Juvenile idiopathic arthritis
- Lyme disease
- Osteoarthritis
- Psoriatic arthritis
- Reactive poststreptococcal arthritis
- Rheumatoid arthritis
- Rheumatic fever
- Serum sickness
- Systemic lupus erythematosus
- Serum sickness–like reactions
- Viral arthritis
Treatment
- D/C antigen
- Diphenhydramamine
- Prednisone
Disposition
Admit for:
- Significant comorbidities (advanced or very young age, immunocompromised)
- Severe symptoms
- Hemodynamic instability/hypotension
- Unclear diagnosis
Prognosis
- Symptoms usually last 1-2 weeks before spontaneously subsiding
- Long-lasting sequelae generally do not occur
- Fatalities are rare and usually are due to continued administration of the antigen