title: Jarisch-Herxheimer Reaction Among Patients with Leptospirosis: Incidence and Risk Factors.
abstract: AbstractA Jarisch-Herxheimer reaction (JHR) may be precipitated after initiation of chemotherapy in spirochetal diseases, including leptospirosis. However, a clear idea of the importance of JHR in this disease is lacking. The incidence of and risk factors for JHR were investigated retrospectively among 262 patients with confirmed leptospirosis who received amoxicillin treatment in New Caledonia and Futuna. The overall rate of JHR was 21% (12% in New Caledonia and 44% in Futuna). Two risk factors were independently associated with JHR occurrence:Leptospira interrogansserogroup Australis as the infecting strain (odds ratio [OR] = 2.60, confidence interval [CI] = 1.40-5.62) and delays < 3 days between the onset of symptoms and the initiation of antibiotherapy (OR = 2.14, CI = 1.11-4.38). Clinicians should be aware of JHR as a potential complication of leptospirosis. Strain-related factors associated with JHR occurrence and its impact on outcome remains to be explored.
authors.affiliation: Anesthésie-réanimation, Hopital Cochin, Paris, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Guerrier
authors.affiliation: Service de médecine, Centre Hospitalier du Nord, Koumac, New Caledonia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lefèvre
authors.affiliation: Dispensaire de Futuna, Agence de Santé, Alo, Futuna.
authors.forename: Chantal
authors.initials: C
authors.lastname: Chouvin
authors.affiliation: Institut de Veille Sanitaire, Cire Océan Indien, Saint-Denis, France.
authors.forename: Eric
authors.initials: E
authors.lastname: D'Ortenzio
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000139:chemically induced*; D007922:Leptospirosis / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents