title: Fatal-Jarisch Herxheimer reaction in a case of relapsing fever misdiagnosed as lobar pneumonia.
abstract: A fatal Jarisch-Herxheimer reaction developed after treatment with high doses of penicillin in a case of lobar pneumonia caused by Borrelia duttoni. Penicillin given on the first day and tetracycline on subsequent days to avoid severe Jarisch-Herxheimer reactions, has the disadvantage of a longer period of spirochetemia and hypotension as compared with tetracycline on the first day. Treatment may have contributed to the death of this patient.
mesh_terms: D000328:Adult; D001831:Body Temperature / Q000187:drug effects; D003951:Diagnostic Errors; D006801:Humans; D007022:Hypotension / Q000139:chemically induced*; D008297:Male; D009127:Muscle Rigidity / Q000139:chemically induced*; D010406:Penicillins / Q000009:adverse effects*; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis*; D012061:Relapsing Fever / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D010406:Penicillins