What is the Jarisch-Herxheimer phenomenon in the pathophysiology of drug eruptions?

Updated: Feb 15, 2019
  • Author: Jonathan E Blume, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Jarisch-Herxheimer phenomenon is a reaction due to bacterial endotoxins and microbial antigens that are liberated by the destruction of microorganisms. The reaction is characterized by fever, tender lymphadenopathy, arthralgias, transient macular or urticarial eruptions, and exacerbation of preexisting cutaneous lesions. The reaction is not an indication to stop treatment because symptoms resolve with continued therapy. This reaction can be seen with penicillin therapy for syphilis, griseofulvin or ketoconazole therapy for dermatophyte infections, and diethylcarbamazine therapy for oncocerciasis.


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