Rash, urticaria, and a fever of 101 with h/o 10 days course of Cefaclor

[Oak]

A 5 year old female is brought to the emergency room with a recent onset of a rash, urticaria, and a fever of 101 degrees F. The mother also states that her son has been complaining that his "bones hurt." Physical examination reveals mild lymphadenopathy. The patient's past medical history is unremarkable except that he just finished a 10-day course of cefaclor suspension for treatment of an upper respiratory infection. The patient should be treated with

A. aspirin and diphenhydramine
B. erythromycin and diphenhydramine
C. intravenous penicillin and diphenhydramine
D. oral prednisone and diphenhydramine
E. topical betamethasone

[bharat]

Originally Posted by Oak

A 5 year old female is brought to the emergency room with a recent onset of a rash, urticaria, and a fever of 101 degrees F. The mother also states that her son has been complaining that his "bones hurt." Physical examination reveals mild lymphadenopathy. The patient's past medical history is unremarkable except that he just finished a 10-day course of cefaclor suspension for treatment of an upper respiratory infection. The patient should be treated with

A. aspirin and diphenhydramine
B. erythromycin and diphenhydramine
C. intravenous penicillin and diphenhydramine
D. oral prednisone and diphenhydramine
E. topical betamethasone

well this is tough question for me
well i would like to thank you for discussing such important topics of management of adverse RXn. of drug here because mostly we only read what are the potential adverse reaction of drug but we dont know how to treat when adverse reaction occur.
well in this case let me make guess hai
well i will go for option D
coz. teratment with glucocorticoid with antihistaminc might be helpfull
waiting for your reply.
well bro yesto question haru aru pani pathunu paryo so we can learn from u

[Oak]

Sorry I was out of town couldn't have time for the net so, I am back now. I missed you all. Ok, here we go:

Yes, The correct answer is D. Serum sickness is a condition commonly caused by hypersensitivity to drugs. It is suggested that the drug acts as a hapten, which binds to plasma proteins. This drug-protein complex is recognized as being foreign to the body and induces the serum sickness. Common signs and symptoms of serum sickness include fever, cutaneous eruptions (morbilliform and/or urticarial), lymphadenopathy, and arthralgias. Erythema multiforme may also appear in severe cases. With respect to cefaclor, the incidence of serum sickness is much higher in infants and children than in adults. Due to the severity of the signs and symptoms in this patient, oral prednisone and diphenhydramine should be administered. The prednisone will treat the arthralgias and the skin rash and the diphenhydramine will alleviate the urticaria.

The use of aspirin (choice A) in a child with a fever is not indicated due to the risk of Reye syndrome. If the patient had not completed his antibiotic therapy and/or signs and symptoms of the infection were still present, switching the antibiotic to a non-beta lactam would be indicated.

Prescribing erythromycin (choice B) for a patient with no signs or symptoms of infection would not be indicated.

Intravenous penicillin (choice C) would not be indicated since there is no infection in this patient, and IV penicillin is reserved for serious infections. In fact, penicillin administration is the most common cause of serum sickness.


Topical betamethasone (choice E) may help to treat the rash and urticaria; however, oral prednisone and diphenhydramine would produce more symptomatic relief.

[bharat]

well bro. its nice you to have you back. well since you were away no one seems to be intresting only hero was left and i felt tierd too.well you are back now well i hope again we will go on smooth but these days i am little busy preparing for exam Coz. i have exams after this holyday about 15 more days are left for my exams so i hope if any question regarding phermacolgy and biochemsitry would be helpfull for me for right now and please if you have some please post it .see u later bro