Jarisch-Herxheimer reaction
Revision as of 11:40, 30 September 2014 by Rossdonaldson1 (talk | contribs)
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
Presentation
- Resembles bacterial sepsis.
- Tends to occur within two hours of antibiotic administration
- Lasts for a few hours or up to a day
Signs & Symptoms
- 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.
Treatment
Complications
- The mortality rate from JHR in louse-borne relapsing fever (LBRF) in the absence of adequate monitoring and resuscitation measures is ~ 5%.
Prognosis
Sources
Harrison's Principles of Internal Medicine