STD

Jarisch-Herxheimer Reaction

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Jarisch-Herxheimer Reaction

  • See Also
  1. Sexually Transmitted Disease
  2. Syphilis
  3. Primary Syphilis
  4. Secondary Syphilis
  5. Latent Syphilis
  6. Tertiary Syphilis
  7. Syphilitic Gumma
  8. Cardiovascular Syphilis
  9. Neurosyphilis
  10. Syphilis Testing
  11. Genital Ulcer
  • Pathophysiology
  1. Spirochetes killed with Antibiotics release pyrogens, resulting in fever and other systemic symptoms
  2. Reaction occurs with treatment of Spirochete infection
    1. Syphilis (reaction occurs variably based on stage)
      1. Primary Syphilis: 50%
      2. Secondary Syphilis: 90%
      3. Latent Syphilis: 25%
    2. Relapsing Fever (Tick-Borne Disease)
  • Signs and Symptoms
  1. General
    1. Fever
    2. Adenopathy
    3. Skin rash
    4. Arthralgias
    5. Malaise
    6. Diaphoresis
  2. Neurologic symptoms
    1. Headache
    2. Seizures
    3. Cerebrovascular Accident
  • Course
  1. Occurs 2 to 6 hours after treatment started
  2. Symptoms last for 24 hours
  • Management
  1. Acetaminophen 2 hours before and after Antibiotic dose
  2. Corticosteroids and NSAIDs do not prevent complications
  3. Maintain hydration
  • References
  1. Kirk, McHugh and Parnell (2023) Crit Dec Emerg Med 37(8): 23-9