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Journal of Case Reports
Jarisch – Herxheimer Reaction in a Patient with Disseminated Lyme Disease
Pooja Kadam, Ki-Tae Mok, Cynthia Carlyn
From the Department of Medicine, Albany VA Medical Center, 113 Holland Avenue, Albany, New York 12208.
Corresponding Author:
Pooja Kadam
Email: pooja.libra27@gmail.com
Received: 06-AUG-2013 Accepted: 31-AUG-2013 Published Online: 15-OCT-2013
DOI: http://dx.doi.org/10.17659/01.2013.0084
Abstract
A 61-year-old man presented with a 2 week history of intermittent fever, recurrent headaches, arthralgia’s and a non-pruritic erythematous macular rash on his right lower abdomen.  The patient underwent an uncomplicated lumbar puncture and was commenced on antibiotics for suspected early disseminated Lyme disease. Few hours after the first antibiotic dose he had abrupt onset of high fevers, chills, hypotension and tachycardia requiring fluid resuscitation and antipyretics. Jarisch-Herxheimer reaction (JHR) is a transient shock-like syndrome that typically follows initiation of antibiotics and is classically associated with penicillin treatment of syphilis. We discuss a patient of disseminated Lyme disease who developed JHR after commencing antibiotic therapy.
Keywords : Lyme Disease, Spirochaetales, Syphilis, Arthralgia, Exanthema, Hypotension.
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