Jarisch-Herxheimer reaction: Difference between revisions

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==Clinical Features==
==Clinical Features==
* Malaise
*Malaise
* [[Fever]]
*[[Fever]]
* 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.



Revision as of 11:12, 4 July 2016

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.

Differential Diagnosis

Diagnosis

Management

Disposition

See Also

References