II. Pathophysiology

  1. 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)

III. 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

IV. Course

  1. Occurs 2 to 6 hours after treatment started
  2. Symptoms last for 24 hours

V. Management

  1. Acetaminophen 2 hours before and after Antibiotic dose
  2. Corticosteroids and NSAIDs do not prevent complications
  3. Maintain hydration

VI. References

  1. Kirk, McHugh and Parnell (2023) Crit Dec Emerg Med 37(8): 23-9

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Related Studies

Ontology: Jarisch Herxheimer reaction (C0259756)

Concepts Injury or Poisoning (T037)
SnomedCT 10803007
English Herxheimer's reaction, Herxheimer reaction, Jarisch-Herxheimer reaction (diagnosis), Jarisch-Herxheimer reaction, herxheimer reaction, jarisch-herxheimer reaction, herxheimer's reaction, jarisch herxheimer reaction, herxheimer reactions, herxheimer jarisch reaction, Jarisch Herxheimer reaction, Jarisch Herxheimer reaction (disorder), Herxheimer; reaction, Herxheimer, reaction; Herxheimer
Italian Reazione di Jarisch-Herxheimer, Reazione di Herxheimer
Dutch Herxheimer-reactie, Herxheimer; reactie, reactie; Herxheimer, Jarisch-Herxheimer-reactie
German Herxheimer-Reaktion, Jarisch-Herxheimer-Reaktion
Portuguese Reacção de Herxheimer, Reacção de Jarisch-Herxheimer
Spanish Reacción de Herxheimer, reacción de Herxheimer (trastorno), reacción de Herxheimer, reacción de Jarisch Herxheimer (trastorno), reacción de Jarisch Herxheimer, Reacción de Jarisch-Herxheimer
Japanese ヤーリッシュ・ヘルクスハイマー反応, ヘルクスハイマー反応, ヘルクスハイマーハンノウ, ヤーリッシュヘルクスハイマーハンノウ
French Réaction d'Herxheimer, Réaction de Jarisch-Herxheimer
Czech Jarisch-Herxheimerova reakce, Herxheimerova reakce
Hungarian Herxheimer-reakció, Jarisch-Herxheimer-reakció