Endotoxemia Associated with the Jarisch-Herxheimer Reaction

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Abstract
The Jarisch-Herxheimer reaction may occur after the initiation of treatment for syphilis. The reaction consists of shaking chills, fever, malaise, sore throat, myalgia, headache, tachycardia and exacerbation of the inflammatory reaction at sites of localized spirochetal infection.1 Severe complications, including an exacerbation of neurologic lesions of neurosyphilis, have been described.2 , 3 The reaction generally occurs six to eight hours after treatment is begun with penicillin or other appropriate antibiotics. It has been observed in about 50 per cent of patients treated for primary syphilis, 75 per cent of those with secondary syphilis, and 30 per cent of those with neurosyphilis.1 2 3 4 It . . .