Herxheimer reaction
| Herxheimer reaction | |
|---|---|
| Classification and external resources | |
| ICD-10 | T78.2 |
| ICD-9 | 995.0 |
The Herxheimer reaction (also known as Jarisch-Herxheimer or Herx) occurs when large quantities of toxins are released into the body as bacteria (typically spirochetes) die during antibiotic treatment. It is classically associated with syphilis.
Typically the death of these bacteria and the associated release of endotoxins occurs faster than the body can remove the toxins. It is manifested by fever, chills, headache, myalgia (muscle pain), and exacerbation of skin lesions. Duration in syphilis is normally only a few hours. The intensity of the reaction reflects the intensity of inflammation present.
The reaction is also seen in other diseases caused by spirochetes, such as borreliosis (Lyme disease and tick-borne relapsing fever) and leptospirosis, and in Q fever.[1] Similar reactions have also been reported to occur in bartonellosis (including cat scratch disease),[2][3] brucellosis,[4] typhoid fever,[5] and trichinosis.[6]
Pathophysiology
The Herxheimer reaction has shown an increase in inflammatory cytokines during the period of exacerbation, including tumor necrosis factor alpha, interleukin-6 and interleukin-8.[7][8]
History
Both Adolf Jarisch,[9] an Austrian dermatologist, and Karl Herxheimer,[10] a German dermatologist, are credited with the discovery of the Jarisch-Herxheimer reaction. Both Jarisch and Herxheimer observed reactions in patients with syphilis treated with mercury. The reaction was first seen following treatment in early and later stages of syphilis treated with Salvarsan, mercury, or antibiotics. It is seen in 50% of patients with primary syphilis and about 90% of patients with secondary syphilis.[1]
References
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pl:Reakcja Jarischa-Herxheimera- ↑ 1.0 1.1 Loscalzo, Joseph; Fauci, Anthony S.; Braunwald, Eugene; Dennis L. Kasper; Hauser, Stephen L; Longo, Dan L. (2008). Harrison's Principles of Internal Medicine. McGraw-Hill Medical. pp. 1048–67. ISBN 0-07-146633-9.
- ↑ Lua error in package.lua at line 80: module 'Module:Citation/CS1/Suggestions' not found.
- ↑ Koehler JE; Duncan LM (September 29, 2005). "Case records of the Massachusetts General Hospital. Case 30-2005. A 56-year-old man with fever and axillary lymphadenopathy". New England Journal of Medicine. 353 (13): 1387–94. doi:10.1056/NEJMcpc059027. PMID 16192484.
- ↑ Madkour MM (2003). "Brucellosis". In D. A. Warrell, Timothy M. Cox, John D. Firth. Oxford Textbook of Medicine. Oxford: Oxford University Press. p. 545. ISBN 0-19-262922-0.
- ↑ Keith Parker; Laurence Brunton; Goodman, Louis Sanford; Donald Blumenthal; Iain Buxton (2008). "Protein synthesis inhibitors and miscellaneous antibacterial agents". Goodman & Gilman's manual of pharmacology and therapeutics. McGraw-Hill Medical. p. 768. ISBN 0-07-144343-6.
- ↑ Grove DI (2003). "Nematode infections of lesser importance". In D. A. Warrell, Timothy M. Cox, John D. Firth. Oxford Textbook of Medicine. Oxford: Oxford University Press. p. 809. ISBN 0-19-262922-0.
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- ↑ Jarisch A (1895). "Therepeutische Versuche bei
Syphilis". Wien Med Wochenschr. 45: 721–42. line feed character in
|title=at position 28 (help) - ↑ Herxheimer K, Krause D (1902). "Ueber eine bei Syphilitischen vorkommende Quecksilberreaktion". Deutsch Med Wochenschr. 28: 895–7. doi:10.1055/s-0028-1139096.
