title: Serum sickness-like reaction with clarithromycin.
abstract: Serum sickness-like reaction is a rare immunological condition which may develop following exposure to certain drugs such as penicillins, cephalosporins, and trimethoprim-sulfamethoxazole, among many others. It is described classically as a type III hypersensitivity response to heterologous proteins. Its true mechanism is still unclear. We present a case of serum sickness-like reaction to clarithromycin, a commonly prescribed drug for the treatment of respiratory tract infections. The patient had been taking this drug for 3 days when she experienced generalized body aches, rash, arthralgia, and shortness of breath, prompting presentation to the emergency department. Laboratory studies showed decreased C4 and total complement with a slightly elevated sedimentation rate. After exclusion of other possible causes, the diagnosis of serum sickness-like reaction was made. The patient responded well to nonsteroidal antiinflammatory medication, antihistamines, and a short, tapering dose of steroids. To our knowledge, serum sickness-like reaction to clarithromycin has never been reported previously. This case emphasizes the need for increased clinical awareness of such an adverse outcome to clarithromycin use.
authors.affiliation: Department of Internal Medicine, St. Mary's Hospital, Waterbury, Connecticut 06706, USA. adnanke@gmail.com
authors.forename: Muhammad Adnan
authors.initials: MA
authors.lastname: Sohail
authors.forename: Junaid
authors.initials: J
authors.lastname: Nasir
authors.forename: Umaira
authors.initials: U
authors.lastname: Ikram
authors.forename: Thomas
authors.initials: T
authors.lastname: Genese
mesh_terms: D017291:Clarithromycin / Q000009:adverse effects*; D005076:Exanthema / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D012713:Serum Sickness / Q000139:chemically induced* / Q000175:diagnosis*
chemical_list: D017291:Clarithromycin