Jarisch-Herxheimer reaction: Difference between revisions
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*Can also occur following treatment of tick-borne relapsing fever (TBRF) or [[Lyme disease]] | *Can also occur following treatment of tick-borne relapsing fever (TBRF) or [[Lyme disease]] | ||
*Both [[penicillin]] and [[tetracycline]] can induce JHR | *Both [[penicillin]] and [[tetracycline]] can induce JHR | ||
*Resembles bacterial sepsis. | *Resembles bacterial sepsis. | ||
*Tends to occur within two hours of antibiotic administration | *Tends to occur within two hours of antibiotic administration | ||
**Lasts for a few hours or up to a day | **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== | |||
[[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'' | |||
*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== | |||
*[[Sepsis]] | |||
==Evaluation== | |||
*Typically a clinical diagnosis | |||
==Management== | |||
*Reassurance | |||
*[[Acetaminophen]] | |||
=== | ==Disposition== | ||
*Outpatient | |||
* | |||
== | ==See Also== | ||
== | ==References== | ||
<References/> | |||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:ID]] | [[Category:ID]] | ||
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