Herxheimer reactionT78.2

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 23.04.2021

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Synonym(s)

Jarisch-Herxheimer reaction; Reaction Jarisch-Herxheimer

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HistoryThis section has been translated automatically.

Jarisch, 1895; Herxheimer, 1902

DefinitionThis section has been translated automatically.

Reaction with fever, chills and other general reactions occurring at the beginning of therapy due to massive decay of the pathogen, e.g. in syphilis. With appropriate therapy, a similar reaction can also occur with tinea capitis profunda, tinea corporis profunda and onchocerciasis.

EtiopathogenesisThis section has been translated automatically.

Rapid disintegration of spirochetes or fungi with release of toxins after the first administration of antibiotics or antifungals.

Clinical featuresThis section has been translated automatically.

For syphilis: 2-6 hours after the first administration of penicillin, with feverish temperatures, flu-like symptoms, arthralgia, chills, headaches. In the rare late stage with an existing aortic aneurysm life-threatening (possible aortic aneurysm rupture due to sudden disintegration of the granulation tissue). No recurrence occurs with the following injections.

ProphylaxisThis section has been translated automatically.

Simultaneous administration of 25-50 mg prednisolone i.v. one hour before or with the initial administration of antibiotics.

Note(s)This section has been translated automatically.

LiteratureThis section has been translated automatically.

  1. Herxheimer K (1902) On a mercury reaction occurring in syphilitic patients. German medical weekly (Berlin) 28: 895-897
  2. Jarisch A (1895) Therapeutic trials for syphilis. Viennese medical weekly 45: 720-721
  3. Leblebicioglu H (2003) Jarisch-herxheimer reaction in leptospirosis. Eur J Clin Microbiol Infect Dis 22: 639
  4. Silberstein P (2002) A case of neurosyphilis with a florid Jarisch-Herxheimer reaction. J Clin Neurosci 9: 689-690

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Last updated on: 23.04.2021