Jarisch-Herxheimer reaction: Difference between revisions
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* Rigors | * Rigors | ||
* Flushing (due to vasodilation) | * Flushing (due to vasodilation) | ||
* [[Hypotension] | * [[Hypotension]] | ||
* Tachycardia | * Tachycardia | ||
**Tachycardia and hyperventilation are accompanied by hypertension, and then by a drop in blood pressure due to vasodilation and declining peripheral pulse. | **Tachycardia and hyperventilation are accompanied by hypertension, and then by a drop in blood pressure due to vasodilation and declining peripheral pulse. | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 12:16, 22 August 2015
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
- 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.