Jarisch-Herxheimer reaction

Herxheimer reaction
Classification and external resources
ICD-10	T78.2
ICD-9-CM	995.0
DiseasesDB	32939
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A Jarisch–Herxheimer reaction (English /ˌjɑːrɪʃ ˈhɛərkshaɪmər/) is a reaction to endotoxin-like products released by the death of harmful microorganisms within the body during antibiotic treatment. The antibiotics are so successful at killing a lot of bacterial cells that now the contents of those burst cells provoke some irritation and must be cleared.

Jarisch–Herxheimer reactions are usually not life-threatening. Often they last only a few hours.

It resembles bacterial sepsis and can occur after initiation of antibacterials, such as mild silver protein, penicillin or tetracycline, for the treatment of louse-borne relapsing fever (80–90% of patients) and in tick-borne relapsing fever (30–40%). An association has been found between the release of heat-stable proteins from spirochetes and the reaction. Typically, the death of these bacteria and the associated release of endotoxins or lipoproteins occurs faster than the body can remove the substances. It usually manifests within a few hours of the first dose of antibiotic as fever, chills, rigor, hypotension, headache, tachycardia, hyperventilation, vasodilation with flushing, myalgia (muscle pain), exacerbation of skin lesions and anxiety. The intensity of the reaction indicates the severity of inflammation. Reaction commonly occurs within two hours of drug administration, but is usually self-limiting.

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