The Jarisch-Herxheimer reaction in syphilis: could molecular typing help to understand it better?

Journal of the European Academy of Dermatology and Venereology : JEADV
M ArandoM Vall-Mayans

Abstract

The Jarisch-Herxheimer reaction (JHR) is a febrile inflammatory reaction that may occur in patients after treatment of syphilis. The overall rate is estimated to be 10-25% with broad variations over time. It appears to be related to factors like stage of the disease or reagin titres. In this study, we aimed to describe the incidence of and risk factors including strain typing for JHR among patients with syphilis. From January through October 2015, 224 consecutive patients (82 of them with HIV) who were diagnosed with early syphilis were enrolled in this prospective observational study in a referral STI clinic in Barcelona. An appointment was offered to them after 10-14 days of treatment to inquire about the reaction with the use of a standardized form. Treponema pallidum molecular typing was made to detect a possible strain related to reaction. Overall, 28% of patients developed JHR. This varied from 56% in secondary, 37% in primary to 7% in early latent syphilis. The most frequent types of reaction were fever (57.5%) and worsening of the lesions (31%). The median time to development of JHR was 6 h [IQR 4-10 h] and lasted a median of 9 h [IQR 4-24 h]. The JHR was less probable in early latent compared to primary/secondary syphi...Continue Reading

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Citations

Sep 29, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Christina M MarraSheila A Lukehart
Sep 24, 2020·Ocular Immunology and Inflammation·Juliana WonsJustus G Garweg
Oct 24, 2020·Journal of the European Academy of Dermatology and Venereology : JEADV·M JanierR Patel
Mar 18, 2021·Epidemiologia E Serviços De Saúde : Revista Do Sistema Unico De Saúde Do Brasil·Francisca Lidiane Sampaio FreitasAngélica Espinosa Miranda
May 18, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Christina M MarraSheila A Lukehart
May 20, 2021·Revista Da Sociedade Brasileira De Medicina Tropical·Francisca Lidiane Sampaio FreitasAngélica Espinosa Miranda
Jul 6, 2021·Indian Journal of Dermatology, Venereology and Leprology·Chao ZhangLei Xiang
Aug 21, 2021·Future Microbiology·Candela Fernández-NavalJuliana Esperalba

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