Serum sickness: Difference between revisions
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==Background== | ==Background== | ||
*A type III hypersensitivity reaction | *A type III [[Hypersensitivity Reaction|hypersensitivity reaction]] | ||
**Secondary to injection of anitoxins (e.g. tetanus, rabies) | **Secondary to injection of anitoxins (e.g. tetanus, rabies) | ||
*Reactions secondary to the administration of nonprotein drugs | *Reactions secondary to the administration of nonprotein drugs | ||
Revision as of 01:23, 21 October 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