Background: Although serum sickness-like reactions (SSLR) are rare in clinical practice, they have been documented to occur following the administration of many medications. The aim of this study is to describe the clinical features of serum sickness-like reactions and the characteristics of this type of presentation. Also, to determine which agents are associated with the development of serum sickness-like reactions in children admitted to a hospital in Tehran, Iran. Methods/Data base: This retrospective study was performed at the hospital of the Children's Medical Center by means of a review of medical charts of children admitted with serum sickness-like reactions during a period of 3 years. Twenty-three hospitalized children with serum sickness-like reactions were evaluated. Results: Of the 23 children with serum sickness-like reactions, 10 cases were related to penicillin drugs, 5 to trimethoprim-sulfamethoxazole, 4 to furazolidone, 2 to wasp stings, and a single case was due to ciprofloxacin and carba-mazepine, respectively. Most of the patients (78.2%) were under 6 years of age and reactions began 5-20 days after exposure to causative agents. Two of the antibiotic-related cases had a history of prior exposure to the same antibiotic. All patients recovered within 1-7 days after withholding the offending agent and providing symptomatic relief. Conclusions: Serum sickness-like reactions to penicillin group drugs may be more common than reported in the literature. So physicians should be familiar with serum sickness reactions particularly as they relate to long-acting penicillin preparations, because accurate diagnosis in conjunction with cessation of drug exposure and prompt initiation of antiinflammatory treatment with corticosteroids can produce complete recovery. Also, clinicians should be aware of the possibility of serum sickness-like reactions associated with insect stings such as by wasps.
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