Jarisch-Herxheimer Reaction

Excerpt

Jarisch Herxheimer reaction (JHR) was first described in the literature by Adolf Jarisch (Austrian dermatologist) in the late 1800s when he noticed an exacerbation of skin lesions in a syphilis patient after starting treatment with a mercurial compound. In the early 1900s, a similar phenomenon was reported by Karl Herxheimer (German dermatologist).

JHR is a transient clinical phenomenon that occurs in patients infected by spirochetes who undergo antibiotic treatment. More specifically, the reaction occurs within 24 hours of antibiotic therapy for spirochetal infections, including syphilis, leptospirosis, Lyme disease, and relapsing fever. It usually manifests as fever, chills, rigors, nausea and vomiting, headache, tachycardia, hypotension, hyperventilation, flushing, myalgia, and exacerbation of skin lesions. JHR is an acute, self-limiting condition and it is important to identify JHR and to distinguish it from allergic reactions and sepsis, which can be life-threatening.