Jarisch-Herxheimer reaction in a patient with syphilis and human immunodeficiency virus infection

Júnior, Aurean D’Eça; Rodrigues, Lívia dos Santos; Costa, Luciana Cavalcante

doi:10.1590/0037-8682-0419-2017

Cited by 3 publications

(2 citation statements)

References 2 publications

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“…Penicillin remains the drug of choice to treat syphilis, and doxycycline has been described as an acceptable alternate option to treat early and late latent syphilis if penicillin cannot be used [ 78 ]. Also worth mentioning is the Jarisch Herxheimer reaction, which may transiently make the patient more symptomatic after initiating antibiotic treatment [ 79 , 80 ]. Although the clinical manifestations and serological results were compatible with a co-infection of measles and secondary syphilis, our observations were limited due to not having performed further additional tests such as PCR for virus detection.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash

et al. 2022

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Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800/µL; neutrophils, 4408/µL; lymphocytes, 406/µL; and platelets, 155,000/µL. Striking findings involving the integumentary system included Koplik’s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for Treponema pallidum. Here we describe the clinical course and management of this patient.

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Section: Discussionmentioning

confidence: 99%

A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash

et al. 2022

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“…The patient was treated with a standard regimen [36]: Intramuscular procaine penicillin G 2.4 units for 14 days and Prednisone 1 mg per kg of body weight two days after antibiotic therapy, tapered over a period of a month. Corticosteroids were used to prevent Jarisch-Herxheimer reaction, whose pathogenesis remains poorly understood [37]; it is probably caused by the release of treponemal breakout products [38]. Simultaneously, he started antiretroviral therapy (ART) for HIV infection [39].…”

Section: Methodsmentioning

confidence: 99%

The Eye as a Window to Systemic Infectious Diseases: Old Enemies, New Imaging

Pirani

Pelliccioni

Turris

et al. 2019

JCM

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Background: Syphilis, tuberculosis and toxoplasmosis are major infectious diseases worldwide; all of them are multisystem pathologies and share a possible ocular involvement. In this context, a fundamental help for the definitive diagnosis is provided by the ophthalmologist, through clinical evaluation and with the aid of a multimodal imaging examination. Methods: We hereby describe selected cases who came to our attention and were visited in our eye clinic. In all clinics, the use of retinal and optic disc multimodal imaging during ophthalmological evaluation allowed to make a diagnosis of an infectious disease. Results: In our tertiary referral center more than 60 patients with syphilis, tuberculosis and toxoplasmosis have been evaluated in the last two years: In 60% of cases the ophthalmological evaluation was secondary to a previous diagnosis of an infectious disease, while in the remaining cases the ophthalmologist, with the help of a multimodal imaging examination and clinical evaluation, represented the physician who leads to the diagnosis. Conclusion: Our results confirm how in these life-threatening pathologies a prompt diagnosis is mandatory and may benefit from a multidisciplinary and multimodal imaging approach, especially during ophthalmological evaluation.

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Jarisch-Herxheimer reaction in a pregnant woman with gestational syphilis

Neto¹

2020

Revista Científica Multidisciplinar Núcleo do Conhecimento

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The Jarisch-Herxheimer reaction is a feverish inflammatory reaction witch may occur after the treatment of patients for syphilis at all stages. Commonly begin between in the first 12 hours after treatment. In pregnant women the reaction may end up in prematurity and fetal death, especially when the fetus is infected. It’s necessary to be aware of all the patient’s complaints and take a look at to group them in a single medical diagnosis whenever possible. And it’s principal that obstetricians always have Jarisch-Herxheimer reaction as a medical diagnosis for febrile syndromes in pregnant women with syphilis.

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Jarisch-Herxheimer reaction in a patient with syphilis and human immunodeficiency virus infection

Cited by 3 publications

References 2 publications

A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash

A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash

The Eye as a Window to Systemic Infectious Diseases: Old Enemies, New Imaging

Jarisch-Herxheimer reaction in a pregnant woman with gestational syphilis

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