title: Jarisch-Herxheimer reaction among syphilis patients in Rio de Janeiro, Brazil.
abstract: The Jarisch-Herxheimer reaction (JHR) is a syndrome observed after antimicrobial treatment of some infectious diseases. The syndrome has clinical characteristics of an inflammatory reaction to antibiotic treatment. A prospective study of patients with a clinical and laboratory diagnosis of syphilis was conducted at a sexually transmitted diseases clinic in Rio de Janeiro, Brazil. Patients were treated with benzathine penicillin and observed for the JHR. A total of 115 patients were included in this study. Fifty-one patients (44%) had secondary syphilis; 37 (32%), primary; 26 (23%), latent; and one (1%), tertiary syphilis. Ten patients (9%) developed the JHR. All JHRs occurred in patients with secondary and latent syphilis. No patients experienced an allergic reaction to penicillin. The JHR occurred less frequently than in previous studies. It is important that health-care professionals recognize the clinical characteristics of the JHR so that it is not misinterpreted as an allergic reaction to penicillin.
authors.affiliation: Sanitary Dermatology Department, Professor Rubem David Azulay Dermatology Institute, Santa Casa da Misericórdia Hospital, Rio de Janeiro, Brazil. wmiller@gt.cdc.gov
authors.forename: W M
authors.initials: WM
authors.lastname: Miller
authors.forename: F
authors.initials: F
authors.lastname: Gorini
authors.forename: G
authors.initials: G
authors.lastname: Botelho
authors.forename: C
authors.initials: C
authors.lastname: Moreira
authors.forename: A P
authors.initials: AP
authors.lastname: Barbosa
authors.forename: A R S B
authors.initials: AR
authors.lastname: Pinto
authors.forename: M F
authors.initials: MF
authors.lastname: Dias
authors.forename: L M
authors.initials: LM
authors.lastname: Souza
authors.forename: M D
authors.initials: MD
authors.lastname: Asensi
authors.forename: J A
authors.initials: JA
authors.lastname: da Costa Nery
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001938:Brazil; D005260:Female; D006801:Humans; D007249:Inflammation / Q000139:chemically induced*; D008297:Male; D010401:Penicillin G Benzathine / Q000008:administration & dosage* / Q000009:adverse effects*; D011446:Prospective Studies; D013587:Syphilis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D010401:Penicillin G Benzathine