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Suggest Treatment For Severe Urticaria

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Posted on Thu, 30 Apr 2015
Question: My 16 year old daughter recently had an allergic reaction. She experienced excessive itching all over her body(her skin started to peel and a red rash appeared). Some of the areas that it he'd the most included the back of her neck, the outside of her ears, inbetween her legs, and under her eyes. Also, she was vomiting constantly for about 12 hours. The next morning the vomiting had ceased and I took her to our primary, who suggested she had serum sickness from a prescription of amoxicillin she finished about three weeks prior for a sinus infection. Also, they took blood, gave her a shot to stop the itching, and suggested she take zertec. The next day the itching hadn't stopped so I called up the doctor again and they told me to take her to the ER. I took her there and they said that it was impossible to pinpoint what was causing the reaction but prescribed her with ranitidine, prednisone, and hydroxyzine. The itching ceased within in 12 hours. But now she had a fever of 100, feels lightheaded, is vomiting up everything she eats, sleeping almost all day, and looks very pale. I don't know where to go from here. Should I stop the antibiotics? Also, she's missed 4 days of school because of this and it doesn't look like she's heading back anytime soon.
doctor
Answered by Dr. Sumanth Amperayani (57 minutes later)
Brief Answer:
Looks like severe urticaria or serum sickness

Detailed Answer:
Hi....by what you quote I feel that there are 2 possibilities -

1. Severe form of allergy or urticaria
2. Serum sickness.

Suggestions -

1. This is definitely not infection - I don't antibiotics are going to help.

2. I suggest you upload the images of the kid and also the scanned copies of the blood test reports.

Skin conditions are best diagnosed and treated after seeing them either directly or in images. That's why thus suggestion.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (13 minutes later)
Hi, the rash is no longer present, the itching also ceased about 12 hours after the zantac, atarax, and deltasone were started. But, now were dealing with a sore body, nausea, fever, and a lightheaded child. Also, the blood results are not in .
doctor
Answered by Dr. Sumanth Amperayani (1 hour later)
Brief Answer:
Should be serum sickness

Detailed Answer:
Hi...as there are no images to be seen I will have to depend on the history you have provided. With an antibiotic being administered 3 weeks and the symptoms fitting in classically, I feel that this is a serum sickness secondary to Amoxycillin for sinus infection. But this can occur to anybody and is unusual - what I mean is that it is not the mistake of the doctor who prescribed the antibiotic.

Coming to your query - This doesn't require antibiotic now and I would like to know if your kid is on any antibiotic now. The other drugs you have mentioned are perfectly fine and I suggest you continue them.

I suggest you get back with the following investigations -

1. CBC - complete blood count and ESR
2. Urinalysis - routine
3. Blood urea nitrogen (BUN) and creatinine levels
4. Serum C3, C4, CH50
5. Immunoglobulin profile

Regards - Dr. Sumanth

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani (1 hour later)
How is serum sickness treated? And how long till it goes away?
doctor
Answered by Dr. Sumanth Amperayani (1 hour later)
Brief Answer:
Suggestions on serum sickness

Detailed Answer:
Hi...

Treatment options -
Antihistamines/ anti allergics - For urticaria. You are using Hydroxizine - it is an antiallergic.

Nonsteroidal anti-inflammatory drugs (NSAIDs) - For severe arthritis.

Steroids - Prednisolone which you are already on.

As to the question of how long does it stay - Serum sickness usually improves in 7 - 10 days, with full recovery in 2 - 4 weeks.

Regards - Dr. Sumanth


Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8339 Questions

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Suggest Treatment For Severe Urticaria

Brief Answer: Looks like severe urticaria or serum sickness Detailed Answer: Hi....by what you quote I feel that there are 2 possibilities - 1. Severe form of allergy or urticaria 2. Serum sickness. Suggestions - 1. This is definitely not infection - I don't antibiotics are going to help. 2. I suggest you upload the images of the kid and also the scanned copies of the blood test reports. Skin conditions are best diagnosed and treated after seeing them either directly or in images. That's why thus suggestion. Regards - Dr. Sumanth