A case of leptospirosis in transcarpathia complicated with Jarisch-Herxheimer reaction

Wiad Lek. 2024;77(3):608-612. doi: 10.36740/WLek202403134.

Abstract

A case report of Jarisch-Herxheimer (JHR) reaction on a 10th day of Leptospirosis caused by Leptospira Pomona. JHR occurs as a complication of an antibiotic treatment of various spirochetes and may lead to respiratory distress syndrome, renal failure, hepatic insufficiency, and multiple organ failure. This case represents a skin and cardio-vascular form of JHR with no lung involvement. The patient was treated with benzylpenicillin and low dexamethasone doses for 5th day of the disease with a shift to ceftriaxone and high doses of methylprednisolone. The fastest diagnosis of a sporadic zoonotic disease, early start of antibiotic therapy, and adequate doses of corticosteroids are key to the successful treatment of leptospirosis.

Keywords: Jarisch-Herxheimer reaction; Leptospirosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents* / adverse effects
  • Anti-Bacterial Agents* / therapeutic use
  • Ceftriaxone / adverse effects
  • Ceftriaxone / therapeutic use
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use
  • Humans
  • Leptospira / isolation & purification
  • Leptospirosis* / complications
  • Leptospirosis* / drug therapy
  • Male
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone
  • Methylprednisolone
  • Dexamethasone