Jarisch-Herxheimer reaction: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
[[File:Jarisch-Herxheimer reaction in patient (cropped).jpg|thumb|Jarisch–Herxheimer reaction in a person with syphilis.]] | |||
''Occurs 2 to 6 hours after treatment started; symptoms can last for 24 hours'' | ''Occurs 2 to 6 hours after treatment started; symptoms can last for 24 hours'' | ||
*Malaise | *Malaise | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Sepsis]] | |||
==Evaluation== | ==Evaluation== | ||
*Typically a clinical diagnosis | |||
==Management== | ==Management== | ||
*Reassurance | |||
*[[Acetaminophen]] | *[[Acetaminophen]] | ||
==Disposition== | ==Disposition== | ||
*Outpatient | |||
==See Also== | ==See Also== | ||
Latest revision as of 22:44, 8 September 2020
Background
- A systemic reaction caused by reaction to endotoxins released by the death of harmful organisms within the body
- Occurs following antibiotic treatment for a number of spirochetal and bacterial infections (classically described in the treatment of syphilis)
- Can also occur following treatment of tick-borne relapsing fever (TBRF) or Lyme disease
- Both penicillin and tetracycline can induce JHR
- Resembles bacterial sepsis.
- Tends to occur within two hours of antibiotic administration
- Lasts for a few hours or up to a day
- Mortality rate from JHR in louse-borne relapsing fever (LBRF) in the absence of adequate monitoring and resuscitation measures is ~5%.
Clinical Features
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Occurs 2 to 6 hours after treatment started; symptoms can last for 24 hours
- Malaise
- Fever
- Rigors
- Flushing (due to vasodilation)
- Hypotension
- Tachycardia
- Tachycardia and hyperventilation are accompanied by hypertension, and then by a drop in blood pressure due to vasodilation and declining peripheral pulse.
Differential Diagnosis
Evaluation
- Typically a clinical diagnosis
Management
- Reassurance
- Acetaminophen
Disposition
- Outpatient