• Skip to main content
  • Skip to primary sidebar
  • Skip to footer
  • Health
  • Presentation
  • Procedures
  • Diseases
  • Women
  • Subscribe
  • About
    • Privacy Policy
    • Contact Us

medcaretips.com

Health, Medicine and Medical Care

telegram channel medcaretips
You are here: Home / Presentation / Jarisch-Herxheimer Reaction – Causes and Treatment

Jarisch-Herxheimer Reaction – Causes and Treatment

By Dr Surbhi Mahajan

toc
    • Causes and Pathophysiology
    • Clinical Presentation
    • Investigations
    • Management

The Jarisch-Herxheimer reaction (JHR) is a transient immunological reaction seen commonly in patients during antibiotics treatment, classically in syphilis but also seen in other diseases like lyme disease and relapsing fever among others.

The Jarisch-Herxheimer reaction manifests clinically with symptoms such as fever, chills, headache and myalgias, besides exacerbation of existing cutaneous lesions.

Jarisch–Herxheimer reactions are usually not life-threatening.

It has been named after Adolf Jarisch, an Austrian dermatologist and Karl Herxheimer, a German dermatologist.

jarisch herxheimer reaction

Causes and Pathophysiology

As said before, Jarisch-Herxheimer’s reaction or Herxheimer reaction was s classically described in the treatment of syphilis and was believed to be caused by the release of endotoxin-like substances when large numbers of Treponema pallidum are killed by antibiotics.

The reaction is also seen in the other diseases caused by spirochetes such as Lyme disease, relapsing fever, and leptospirosis.

Other diseases where Jarisch-Herxheimer reaction has been reported are, bartonellosis, brucellosis, trichinellosis, and African trypanosomiasis.

The exact mechanism is not clear yet.

An increase in inflammatory cytokines during the period of exacerbation, including tumor necrosis factor alpha, interleukin-6 and interleukin-8 has been noted.

Clinical Presentation

The symptoms of reaction are seen  between 1 and 12 hours after the first injection of antibiotics and lasts for a few hours or up to a day. It is not seen with subsequent treatment.

Patient complains of  malaise, slight-to-moderate fever. There is a  flush due to vasodilation. Increase in heartbeat is noted.

Any existing skin lesions become more prominent.

There is hyperventilation and  hypertension followed by a drop in blood pressure due to vasodilation and declining peripheral resistance.

Blood examination would show leukocytosis.

Usually, the reaction resolves over a period of 6-12 hours.

Investigations

Serological tests for syphilis are indicated if the reaction is noted unexpectedly..

Management

No treatment is usually required for the reaction per se. It is a self-limiting condition and often resolves within 24 hours.

Symptom controlling measures may be taken in case the symptoms are severe.

Treatment of severe leptospirosis-related Jarisch-Herxheimer reaction with fluid infusion, vasopressors, corticosteroids, inotropic support and transient dialysis has been reported.

Spread the Knowledge
  • 2
  •  
  • 2
  •  
  •  
  •  
    4
    Shares
  • 2
  •  
  •  
  • 2
  •  

Filed Under: Presentation

About Dr Surbhi Mahajan

Dr Surbhi Mahajan, MD Pathology, is pathologist at Kanwar Hospital, Hajipur and Kanwar Path Lab, Dasuya.

She is cofounder of MedCaretips.com

When she is not working on her lab projects, she writes for MedCareTips.com

Primary Sidebar

Subscribe to updates

Receive articles in your inbox !!
Enter your email address below

Syndrome of Inappropriate Antidiuretic Hormone Secretion

The syndrome of inappropriate antidiuretic hormone secretion is defined by the hyponatremia, hypo-osmolality of plasma and increases osmolality of … [Read More...] about Syndrome of Inappropriate Antidiuretic Hormone Secretion

Prothrombin Time

Prothrombin Time and International Normalized Ratio or PT/INR

Prothrombin time or PT test is a blood test that is used to measure the time it takes for blood to clot. The results of this test can be expressed in … [Read More...] about Prothrombin Time and International Normalized Ratio or PT/INR

diet for breastfeeding mother

Diet for Breastfeeding Mothers – What to Eat and What to Avoid?

Breastfeeding mothers spend extra calories. Though what a mother eats … [Read More...] about Diet for Breastfeeding Mothers – What to Eat and What to Avoid?

vagus nerve stimulation implant diagram

Vagus Nerve Stimulation- Indications and Risks

Vagus nerve stimulation is a medical procedure that delivers … [Read More...] about Vagus Nerve Stimulation- Indications and Risks

Myths and facts about breastfeeding

12 Breastfeeding Myths and Facts That Every Mother Should Know

A lot of information regarding breastfeeding is available on the … [Read More...] about 12 Breastfeeding Myths and Facts That Every Mother Should Know

vagus nerve anatomy

Vagus Nerve Anatomy, Course and Function

Vagus nerve is a cranial nerve [arises from brain] that contains both … [Read More...] about Vagus Nerve Anatomy, Course and Function

Breast pump

Breast Pump – Types, Working, Uses and Selection Tips

A breast pump is a mechanical device used by breastfeeding mothers to … [Read More...] about Breast Pump – Types, Working, Uses and Selection Tips

Footer

Most Read Articles

  • Vacutainer and Their Use in Blood Sampling
  • Tepid Water Sponging and Cold Sponging for Fever
  • Dermatomes and Myotomes of Lower Limb

Like and Follow

Like and Follow

Copyright © 2019 ·News Pro · Genesis Framework by StudioPress · WordPress · Log in