J Li1, L-N Wang, H-Y Zheng. 1. Department of Dermatology and Venereology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Abstract
BACKGROUND/AIM: The Jarisch-Herxheimer reaction (JHR) is an acute systemic event that can occur during the treatment of spirochetal infections, especially Treponema pallidum in patients with syphilis. JHR has clinical characteristics of an inflammatory reaction to antibiotic treatment and can occur with many medications as long as the antitreponemal concentrations are sufficiently high. METHODS: The incidence of and risk factors for JHR were investigated retrospectively among 1125 patients with syphilis. A total of 357 patients (32%) had secondary syphilis, 129 (12%) primary, 178 (16%) early latent, 174 (15%) late latent and 285 (25%) latent unknown duration; two patients had tertiary syphilis. RESULTS: Sixteen patients (1.4%) developed JHR. All JHRs occurred in patients with secondary and latent syphilis treated with penicillin. CONCLUSIONS: JHR occurred much less frequently than in previously reported studies. It is important that dermatologists recognize the clinical characteristics of JHR so that it is not misinterpreted as an allergic reaction to treatment.
BACKGROUND/AIM: The Jarisch-Herxheimer reaction (JHR) is an acute systemic event that can occur during the treatment of spirochetal infections, especially Treponema pallidum in patients with syphilis. JHR has clinical characteristics of an inflammatory reaction to antibiotic treatment and can occur with many medications as long as the antitreponemal concentrations are sufficiently high. METHODS: The incidence of and risk factors for JHR were investigated retrospectively among 1125 patients with syphilis. A total of 357 patients (32%) had secondary syphilis, 129 (12%) primary, 178 (16%) early latent, 174 (15%) late latent and 285 (25%) latent unknown duration; two patients had tertiary syphilis. RESULTS: Sixteen patients (1.4%) developed JHR. All JHRs occurred in patients with secondary and latent syphilis treated with penicillin. CONCLUSIONS: JHR occurred much less frequently than in previously reported studies. It is important that dermatologists recognize the clinical characteristics of JHR so that it is not misinterpreted as an allergic reaction to treatment.
Authors: Antonello Di Paolo; Giovanni Gori; Carlo Tascini; Romano Danesi; Mario Del Tacca Journal: Clin Pharmacokinet Date: 2013-07 Impact factor: 6.447
Authors: Tais F Galvao; Marcus T Silva; Suzanne J Serruya; Lori M Newman; Jeffrey D Klausner; Mauricio G Pereira; Ricardo Fescina Journal: PLoS One Date: 2013-02-21 Impact factor: 3.240