A 5-year-old boy with acute bacterial meningitis due to Streptococcus pneumoniae is treated with ceftriaxone and vancomycin. On hospital day 2, he develops a diffuse maculopapular rash sparing palms and soles, fever (39.2°C), and arthralgias. Vital signs show HR 118/min, BP 105/68 mmHg, RR 24/min. WBC is 14,200/μL with left shift. He denies recent antibiotic allergies. Which medication is most likely responsible for this reaction, and what is the recommended management?
- A)Stevens-Johnson syndrome; discontinue ceftriaxone and treat supportively
- B)Anaphylaxis; administer epinephrine and airway support
- C)Drug fever from impure ceftriaxone preparation; switch to alternative antibiotic
- D)Serum sickness-like reaction; continue ceftriaxone with antihistamine supportGABARITO
- E)Meningococcemia; switch to vancomycin immediately
Explicação
Serum sickness-like reaction (SSLR) is a common hypersensitivity response to cephalosporins, particularly in pediatric patients. It presents with rash, fever, and arthralgias typically 1-3 weeks after drug initiation but can occur sooner. The rash characterist... Ver explicação completa e trilha adaptativa →