The Royal Children's Hospital Melbourne. This guideline has been adapted for statewide use with the support of the Victorian Paediatric Clinical Network. Signs and symptoms of true serum sickness occur one to two weeks after first exposure, while SSLRs usually develop after 5 to 10 days.
Identification and removal of the causative agent is the key, but note treatment may have been ceased prior to appearance of rash. Background True Serum Sickness is a delayed hypersensitivity reaction, triggered by: Snake anti-venom, equine and rabbit anti-thymocyte globulin ATG Monoclonal antibody drugs such as Rituximab are most often implicated.
Insect stings eg: bees Antiserum — rabies and tetanus Serum Sickness-Like Reaction SSLRs , which are more common in children, can cause a similar but less severe clinical picture, without measurable immune-complex formation. Assessment History Explore events in the two - weeks before onset of symptoms: Illness Immunisation Antibiotics Other medication history Explore each symptom in detail: Rash — children with SSLRs usually present with urticarial-type lesions see images below , often appearing first in flexural areas and then becoming more generalised.
Unlike acute urticaria, the lesions often persist for days in the same area. The rash tends to be pruritic. Arthralgia — acute joint pain, limp or inability to walk. Fever may not develop in those with an SSLR, and tend to be low-grade. Examination Rash — in SSLRs the skin lesions start in the flexures, but often appear more generalised. There does not appear to be any cross-reactivity between cefaclor with other cephalosporins or beta lactam antibiotics. The reaction to cefaclor appears to be due to a specific metabolite produced where there is an inherited variant pathway to break down this medication.
See smartphone apps to check your skin. DermNet NZ does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice.
Serum sickness-like reaction — codes and concepts open. Reaction to external agent. Adverse skin and joint reactions associated with oral antibiotics in children: The role of cefaclor in serum sickness-like reactions. Child Health ; — A four-year-old boy with fever, rash, and arthritis. Cutaneous reactions to drugs in children. E-mail Form. Serum sickness Serum sickness describes a delayed immune system response, either to certain kinds of medications or to antiserum given after a person has been bitten by a snake or to counter exposure to rabies, for example.
Signs and Symptoms The first signs of serum sickness are redness and itching at the injection site. Other signs and symptoms include: Skin rash, hives Joint pain Fever Malaise feeling unwell Swollen lymph nodes Itching Wheezing Flushing Diarrhea, nausea, and abdominal cramping. What Causes It? Penicillin is the most common cause of serum sickness. Other causes include: Other antibiotics, including cephalosporins Fluoxetine Prozac used for depression Barbiturates A class of diuretics called thiazides Products that contain aspirin Many other medications Snake venom antiserum Bee or wasp sting rare.
Who is Most At Risk? You are more likely to suffer from serum sickness if: You are injected with one of the drugs or antitoxin known to cause serum sickness. You need a large amount of snake venom antiserum. You have previously been exposed to a drug or antitoxin known to cause serum sickness. What to Expect at Your Provider's Office Your doctor will look for typical symptoms and ask if you have been recently exposed to any antiserum.
Treatment Options Prevention If you know you are sensitive to a particular drug or antiserum, you should tell your health care provider before you get any kind of injection. A provider can perform skin tests to check for serum sensitivity before giving antiserum. If you are sensitive to an antiserum, your provider may use a method that desensitizes you to the antiserum, at least temporarily.
Drug Therapies Treatment for serum sickness is aimed at reducing symptoms. Complementary and Alternative Therapies If you suspect you have serum sickness, you should see a doctor immediately and receive conventional medical treatment. Nutrition and Supplements The following nutrients may help support your immune system and reduce allergic reactions, though there is no scientific evidence they will be effective for serum sickness.
Following these nutritional tips may help reduce risks and symptoms: Eliminate all suspected food allergens, including dairy, wheat gluten , soy, corn, preservatives, and chemical food additives.
Your health care provider may want to test you for food allergies. Eat foods high in B-vitamins and iron, such as whole grains if no allergy , dark leafy greens such as spinach and kale , and sea vegetables. Eat antioxidant-rich foods, including fruits such as blueberries, cherries, and tomatoes , and vegetables such as squash and bell pepper. Avoid refined foods, such as white breads, pastas, and sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu soy, if no allergy , or beans for protein. Use healthy oils for cooking, such as olive oil or vegetable oil. Reduce significantly or eliminate trans-fatty acids, found in commercially-baked goods such as cookies, crackers, cakes, and donuts. Also avoid French fries, onion rings, processed foods, and margarine. Avoid coffee and other stimulants, alcohol, and tobacco. Drink 6 to 8 glasses of filtered water daily.
Exercise moderately for 30 minutes daily, 5 days a week. Acupuncture Traditional Chinese Medicine and acupuncture can help lessen the body's tendency toward allergic hypersensitivity reactions. Massage DO NOT use massage to treat serum sickness as it may promote inflammation and lower blood pressure. Following Up Health care providers should monitor seriously ill people for rare instances of myocarditis inflammation of the heart muscle and peripheral neuritis nerve inflammation.
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