Just look at the rash – then scroll down to reveal the diagnosis. That’s it. This child was placed on Amoxicillin for acute otitis media and this rash developed after 9 days of treatment. The child has fever and swollen feet as well.
It’s Serum Sickness Like Reaction!
This is a delayed allergic reaction to an antibiotic. Another name would be Urticaria Multiforme with systemic symptoms and joint involvement. The main treatment is discontinuing the antibiotic. You can also add cetirizine (even twice daily), and H2 blockers like Cimetidine if the symptoms become more significant. Tell families that this rash will always look worse on days 2,3, and 4 an to not be alarmed. Your hospital might even have a specific clinic to follow this up – like the PATS – Penciling Allergy Testing Service at Cincinnati Children’s.
