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Lipoproteins released from treatment of Treponema pallidum infections are believed to induce the Jarisch–Herxheimer reaction. [3] 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 .
Adolf Jarisch (February 15, 1850 – March 21, 1902) was an dermatologist from the Austro-Hungarian Empire who specialized in the care of venereal disease.The Jarisch-Herxheimer reaction, an inflammatory response that he noted following treatment for syphilis, is partially named after him.
Serum sickness is a type III hypersensitivity reaction, caused by immune complexes. [2] When an antiserum is given, the human immune system can mistake the proteins present for harmful antigens . The body produces antibodies, which combine with these proteins to form immune complexes. [ 2 ]
The Jarisch-Herxheimer reaction, which is the response to the body after endotoxins are released by the death of harmful organisms in the human body, starts usually during the first day of antibiotic treatment. [16] The reaction increases the person's body temperature, decreases the overall blood pressure (both systolic and diastolic levels ...
Up to 40% of pregnant women treated for congenital syphilis will develop a Jarisch-Herxheimer reaction, which is a temporary reaction that usually occurs within a few hours of starting penicillin and resolves by 24 hours. The reaction is characterized by cramping, fever, muscle aches and a rash.
The Jarisch–Herxheimer reaction is an immune-mediated response to syphilis therapy occurring within 2–24 hours. The exact mechanisms of reaction are unclear, however most likely caused by proinflammatory treponemal lipoproteins that are released from dead and dying organisms following antibiotic treatment.
All patients treated with antibiotics should be observed during the first 4 hours of treatment for a Jarisch-Herxheimer reaction, which is a worsening of symptoms characterized by rigors, hypotension, and high fever. [5] The reaction occurs in over 50% of cases and may be difficult to distinguish from a febrile crisis. [5]
True Jarisch-Herxheimer reactions are generally transient, mild, and found only within the first 24 hours of beginning antibiotics. [48] [8] In online Lyme groups, patients have claimed to "herx" long after initial antibiotic treatment for durations that can last weeks. [8]