Serum sickness-like reaction to Augmentin

[dut]

Hi - Our dd7's latest PANDAS episode has had some lingering symptoms (oppositional behaviour, tantrums, emotional lability, fears and night time issues)which were responding really well to Augmentin. We usually use zith. With the exception of needing to come into bed with me in the night, 7 days of augmentin had seemed to do the job - hooray!

 

Unfortunately, day 8 brought a serum sickness-like reaction. Similar to but different from a classic Type 1 allergic reaction. She has had the hives, swelling etc but has also had joint involvement which at day 7 from stopping the abx is getting worse. Unless she's pumped full of anithistamines and painkillers, she's having trouble walking. Even pumped full, the poor child's in a lot of pain. We have been told to expect it to take up to 3 weeks or more for it to resolve as she has produced antibodies (half life of 20 days) and so she will have joint pain, swelling and vasculitis symptoms 'til then.

 

This kind of a reaction is a type III hypersensitivity (as is post strep glomerulonephrits {GN} and Lupus).

 

I was wondering if anyone had had any experience with this?

 

If so, did you have any kidney,liver or heart involvement?

 

Would this make her more likely to experience post strep GN or Lupus?

 

Anything else I should know.. I can't really find much out there about it... so any ideas are really welcome.

 

(Dr has checked the possibility of it being RF but low CRP and ESR, WBC and temporal association with the Augmentin seem to rule it out.)

[Stephanie2]

Please get in touch with "fixit" from this forum. You can search for her and send her a private message. She had something similar and it turned out to be yeast from the abx. When she tried augmentin again with diflucan, no joint pain...

[dut]

Hi - we think it's the serum thingy 'cos as well as joint pain she had full body vasculitis type rashes (that leave the bruises), she had very bad swelling on her face and arms, legs and ankles, had red hot, red coloured and very swollen elbows and knees for 24 hours and now, in addition to the joint pain, she also has dermographism where she goes red wherever she is touched. Could this still be a yeast issue?

 

Our immunologist did feel that these reactions happen when the body sees both the drug AND and infectious agent and gets confused and assumes it's seeing a disease it has seen before and thus produces rampant antibodies. Maybe this could happen with yeast too? dunno....

 

I'll pm fixit too.. thanks

Edited September 10, 2010 by dut

[amy s]

Hi - Our dd7's latest PANDAS episode has had some lingering symptoms (oppositional behaviour, tantrums, emotional lability, fears and night time issues)which were responding really well to Augmentin. We usually use zith. With the exception of needing to come into bed with me in the night, 7 days of augmentin had seemed to do the job - hooray!

 

Unfortunately, day 8 brought a serum sickness-like reaction. Similar to but different from a classic Type 1 allergic reaction. She has had the hives, swelling etc but has also had joint involvement which at day 7 from stopping the abx is getting worse. Unless she's pumped full of anithistamines and painkillers, she's having trouble walking. Even pumped full, the poor child's in a lot of pain. We have been told to expect it to take up to 3 weeks or more for it to resolve as she has produced antibodies (half life of 20 days) and so she will have joint pain, swelling and vasculitis symptoms 'til then.

 

This kind of a reaction is a type III hypersensitivity (as is post strep glomerulonephrits {GN} and Lupus).

 

I was wondering if anyone had had any experience with this?

 

If so, did you have any kidney,liver or heart involvement?

 

Would this make her more likely to experience post strep GN or Lupus?

 

Anything else I should know.. I can't really find much out there about it... so any ideas are really welcome.

 

(Dr has checked the possibility of it being RF but low CRP and ESR, WBC and temporal association with the Augmentin seem to rule it out.)

 

 

Hi dut:

 

I wanted to respond real quick to your post. When my dd was 3 she had post infectious glomerulonephritis. We believe that it was post strep, but at the time it wasn't tested. Her major pandas hit at late age 5. When that hit she had a lot of joint pain. She had heart murmurs age 4-5-6-7 but echo was clear. In our case, it had nothing to do (the post glomerulonephritis) with any antibitiocs because her illness preceding the kidney involvement was considered viral and she was not put on antibiotics at the time. I just wanted to let you know our experience. Good luck to your family!!!! Feel free to pm me.

Regards,

amy s

[3boysmom]

Could it be HSP? (autoimune illness from strep)

[dut]

Thanks for your responses... it's good to hear others' experiences and ideas...

 

I feel as though we've been dealing with behavioural for so long that I'm surprised that this very physical issue has sucker punched me so hard. It's just very hard watching her be in pain and being so brave about it as she crawls her way off the sofa backwards and slowly hobbles round. You feel as though your kid just can't catch a break. I know you all will understand this feeling...

 

thanks again.. off to do more researching, will look up HSP 3boysmom and amy s, I had bad kidney issues for about a year round the age of 6/7 that never really got explained just slowly resolved..

[DebC]

I had serum sickness this past May from Augmentin for a sinus infection. I had an anaphylactic reaction to cephalosporins 5 years previously but the doctor hoped that Augmentin would be okay as I had tolerated it a few years ago. I started taking the antibiotic on a Thursday and always watch myself closely for any sort of allergic reaction. After only 2 doses, my joints ached slightly so I discontinued use and called my doctor. She said to stop taking. By Tuesday, 5 days later, a slight rash appeared. By Wednesday, I was covered in this rash. By Thursday, my joints all over my body were huge and I could hardly bend my knees and fingers. By Friday, I added a fever of slightly over 100 to this. My doctor put me on an 8 day taper or so. Within 12 hours of taking the prednisone, I felt quite a bit better. If I recall, the swelling was gone after a few days. The pin prick rash all over my body lasted for 14 to 21 days but gradually faded during this time. Hopefully this gives you an idea of the timeline of this condition. I had blood drawn at a lab 3 to 4 times during this illness to verify that there was no involvement of major organs. All came out fine and I have no lasting effects. I'm so sorry that your daughter is having to endure this as I'm sure she feels to be about 80 years old as I did. Miserable is the only word that can describe how you feel with this. I can laugh at myself now, but one of my worst moments with it was getting stuck on the toilet and not being able to stand from sitting as my knees just wouldn't do it and there was nothing to pull up on. I think I was there for 45 minutes before I made it up as the kids were in school and my husband was at work. Please let me know if you have any questions and keep us posted as to how your daughter is doing.

[Fixit]

Hi - Our dd7's latest PANDAS episode has had some lingering symptoms (oppositional behaviour, tantrums, emotional lability, fears and night time issues)which were responding really well to Augmentin. We usually use zith. With the exception of needing to come into bed with me in the night, 7 days of augmentin had seemed to do the job - hooray!

 

Unfortunately, day 8 brought a serum sickness-like reaction. Similar to but different from a classic Type 1 allergic reaction. She has had the hives, swelling etc but has also had joint involvement which at day 7 from stopping the abx is getting worse. Unless she's pumped full of anithistamines and painkillers, she's having trouble walking. Even pumped full, the poor child's in a lot of pain. We have been told to expect it to take up to 3 weeks or more for it to resolve as she has produced antibodies (half life of 20 days) and so she will have joint pain, swelling and vasculitis symptoms 'til then.

 

This kind of a reaction is a type III hypersensitivity (as is post strep glomerulonephrits {GN} and Lupus).

 

I was wondering if anyone had had any experience with this?

 

If so, did you have any kidney,liver or heart involvement?

 

Would this make her more likely to experience post strep GN or Lupus?

 

Anything else I should know.. I can't really find much out there about it... so any ideas are really welcome.

 

(Dr has checked the possibility of it being RF but low CRP and ESR, WBC and temporal association with the Augmentin seem to rule it out.)

 

 

Ds had horrible joint pain with aug...

but via doc t and dan..thought joint pain related to previous illness..

 

but when dan wanted to retest aug after we just had joint pain about 4 weeks prior...

he said that do to ds reaction was not immediate..but a week to 10 days in it was more than likely that aug was like nuclear bomb just wiping out everything..not picking and chooseing..and what ever is left just slushes back in like wet sand at the beach...

so per his knowledge and confidence we tried again with diflucan..i don't know that probiotics can stave off the power of aug...

so we did do 30 days of aug xr and diflucan no joint pain.....(yes he had some hotness too...can't remember if rash...so tired...too many kids)

 

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