Jarisch-Herxheimer reaction: Difference between revisions

Revision as of 11:40, 30 September 2014

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

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
-Jarisch-Herxheimer reaction (JHR), also known as the Herxheimer's reaction, is a systemic reaction that believed to be caused by a reaction to endotoxins released by the death of harmful organisms within the body.
+*A systemic reaction caused by reaction to endotoxins released by the death of harmful organisms within the body
-It occurs following antibiotic treatment for a number of spirochetal and bacterial infections.
+*Occurs following antibiotic treatment for a number of spirochetal and bacterial infections (classically described in the treatment of syphilis)
-It was classically described in the treatment of syphilis. It is believed to be caused by release of endotoxin-like substances when large numbers of ''Treponema Pallidum'' are killed by antibiotics. It also has been documented in tick-borne diseases such as [[Lyme]] disease.
+*Can also occur following treatment of tick-borne relapsing fever (TBRF) or [[Lyme disease]]
+*Both [[penicillin]] and [[tetracycline]] can induce JHR
 ==Presentation==
-It resembles bacterial sepsis. Both [[penicillin]] and [[tetracycline]] can induce JHR. JHR can also occur following treatment of tick-borne relapsing fever (TBRF). These reactions tend to occur within two hours of antibiotic administration. Thus, observation for several hours after treatment is recommended. The reaction lasts for a few hours or up to a day. It is not usually seen with subsequent treatment.
+*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
+* [[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
+[[Category:Drugs]]
+[[Category:ID]]