Serum sickness: Difference between revisions
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**Amoxicillin, cefaclor, [[cephalexin]] (Keflex), trimethoprim-sulfamethoxazole | **Amoxicillin, cefaclor, [[cephalexin]] (Keflex), trimethoprim-sulfamethoxazole | ||
== | ==Clinical Features== | ||
*Primary occurs 6-21 days after exposure | *Primary occurs 6-21 days after exposure | ||
**1-4 days after subsequent exposures to the same antigen | **1-4 days after subsequent exposures to the same antigen | ||
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{{Differential Diagnosis Polyarthritis}} | {{Differential Diagnosis Polyarthritis}} | ||
==Diagnosis== | |||
==Treatment== | ==Treatment== | ||
*D/C antigen | *D/C antigen | ||
*Diphenhydramamine | *[[Diphenhydramamine]] | ||
*Prednisone | *[[Prednisone]] | ||
==Disposition== | ==Disposition== | ||
Revision as of 06:24, 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
Clinical Features
- 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
Diagnosis
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