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Serum Sickness, Pediatric

Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Serum sickness

    • Type III hypersensitivity reaction that occurs 7 to 21 days after injection of foreign protein or serum (e.g., biologics or streptokinase)

    • Immune complexes deposit in th...

DIAGNOSIS

HISTORY

  • Suspect in any patient who has been taking any new drug during the past 2 months and who has an unexplained vasculitic rash.

  • Presentation and evolution of rash

    • Typically, the rash first...

TREATMENT

GENERAL MEASURES

  • Stop suspected medication/antigen immediately.

  • Topical steroids to relieve itching

  • Antihistamines to inhibit the action of vasoactive mediators

  • Antipyretics for fever

  • NSAIDs to r...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

When to expect improvement: 
  • Usually self-limited illness that resolves in a few days to weeks after stopping the culprit agent

  • If symptoms persist for >1 month,...

ADDITIONAL READING

  • Bettge AM, Gross G. A serum sickness-like reaction to a commonly used acne drug. JAAPA.  2008;21(3):33–34. [View Abstract on OvidInsights]

  • Bonds RS, Kelly BC. Severe serum sickn...

CODES

ICD9

  • 999.59 Other serum reaction

  • 999.52 Other serum reaction due to vaccination

  • 999.51 Other serum reaction due to administration of blood and blood products

ICD10

  • T80.69XA Other serum reaction due t...

FAQ

  • Q: My child broke out all over her body with an itchy rash and hives a few days after taking cefaclor. Was this serum sickness?

  • A: It is more likely that she is allergic to cefaclor. The difference...

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