Jarisch-Herxheimer reaction

[Guest guest]

In a message dated 10/11/2001 10:46:57 PM Eastern Daylight Time,

badway2@... writes:

> I have been herxing on 200mgDoxycyclinefor two weeks,and on October 5,2001

> went home from my job as agrocery clerk after working two hours of a eight

> hour shift withthese symptoms:wooziness,chills,joint pain,and malaise.Can

> anyone relate to this experience,and how have you coped withherxing?PG

>

>

Hi PG,

Herxing can be very rough but I've had all the symptoms you describe

and more... See if you can ride it out it usually cycles by weeks like 2-3

then you feel well for 2 then you feel awful for 2 and so on... If it gets to

be too much call your doctor and maybe he or she can adjust the dose...

Robyn In NJ

" It is not important how much the soul loves,

but

Rather how much the Soul IS Loved. "

[Guest guest]

Here are just a very few published, mostly peer reviewed articles, with

sources and citations given.

J Emerg Med. 1998 May-Jun;16(3):437-8.

Lyme disease complicated by the Jarisch-Herxheimer reaction.

Maloy AL, Black RD, Segurola RJ Jr.

The Department of Emergency Medicine, Hospital of Saint Raphael, New

Haven, Connecticut 06511, USA.

A 31-year-old woman diagnosed with Lyme disease was treated with

amoxicillin. One hour after the first antibiotic dose, the patient

became acutely ill. She developed hypertension, fever, and rigors.

Shortly afterward, she became hypotensive and required fluid

resuscitation. This systemic illness, the Jarisch-Herxheimer reaction,

was first noted in association with antibiotic therapy for

neurosyphilis. Thus, the institution of antibiotic therapy may be

complicated by the Jarisch-Herxheimer reaction.

PMID: 9610974 [PubMed - indexed for MEDLINE

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Herxheimer's reaction definition - medical

Herx·hei·mer's reaction (hûrks & #712;h & #299; & #716;m & #601;rz,

h & #277;rks & #712;-)

noun

An inflammatory reaction in tissues infected by spirochetes, as in

syphilis or Lyme disease, induced in certain cases by treatment with

salvarsan, mercury, or antibiotics. Also called Jarisch-Herxheimer

reaction.

http://www.yourdictionary.com/medical/herxheimer-s-reaction

[My note: Mercury or salvarsan were old treatments and NOT recommended.]

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[My note: The excerpt below is mainly about RA---- but the 'herx' is the

same.]

Education / Brochure Sheets / Jarisch-Herxheimer Reaction

Jarisch-Herxheimer Reaction

The Jarisch -Herxheimer, or Herxheimer reaction, was named for the

German dermatologist, Karl Herxheimer (1844-1947). Dorlands Medical

Dictionary refers to the Herxheimer reaction as a transient, short-term,

immunological reaction commonly seen following antibiotic treatment of

early and later stage [infectious] diseases which [may be] manifested by

fever, chills, headache, myalgias (muscle pain), and exacerbations of

cutaneous lesions. The reaction has been attributed to liberation of

endotoxins-like substances or of antigens (a substance which causes an

immune reaction) from the killed or dying microorganisms.

A TRANSIENT SHORT-TERM, IMMUNOLOGICAL REACTION

What does this mean in layman's terms? The Herxheimer flare reaction may

be the first indication that the antibiotic is reaching its target and

is therefore considered a good sign. In his original book, The Road

Back, the late McPherson Brown, MD noted that the reaction caused

a temporary worsening of symptoms.

The amount of medication may be directly related to the intensity of the

flare. Medications which have no effect on mycoplasma (or other

microbes) do not provoke this reaction nor do these medications

generally have a favorable long-term effect on the disease. Unlike the

RA flare, which can last for weeks or even months, the Herxheimer flare

reaction is often of short duration. (Scleroderma patients who do not

exhibit inflammatory components to their disease generally do not report

a Herxheimer of clinical significance.)

Large doses of antibiotics may initially caused a worsening or flare

reaction in many of the rheumatic diseases. The rheumatic diseases which

are most hypersensitive (rheumatoid arthritis, lupus, psoriatic

arthritis, etc.) have shown similar, distinct and often severe flare

reactions from even a low dose of antibiotic. According to Dr. Brown,

when the resulting released toxins go to the joints, joint pain is the

result; when they go to the brain, depression may result.

Dr. Brown found the Herxheimer effect showed a number of important

principles at work. It demonstrated that the disease was a

hypersensitive reaction, not to the drug itself, but to the toxins that

a microbe creates in response to the drug's presence. And, it opened the

way to a chemical attack (with medications) on the whole area of

arthritis and rheumatic diseases.

Dr. Brown found that rheumatic diseases are often associated with a high

degree of tissue sensitivity.

It was soon observed that a more potent antibiotic would produce a more

marked flare reaction because of this tissue sensitivity. By keeping the

dosage low, it was possible to gradually remove the microorganisms from

the tissues without causing major clinical worsening of the disease. If

these microorganisms were truly present and responsible for the

hypersensitivity reaction, long term, low dose treatment would result in

clinical improvement of symptoms in patients.

Dr. Brown recognized he was not dealing with an ordinary infectious

problem where microbial invasion was the prominent feature. The reaction

of the patient to the infectious organism was as important as the

organism itself.

http://www.roadback.org/index.cfm/fuseaction/education.display/display_i\

d/91.html

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A Google search (jarisch herxheimer reaction lyme disease) produced

these citations.

http://www.ncbi.nlm.nih.gov/sites/entrez

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Dr. Burrascano mentions the Jarisch-Herxheimer reaction in his

guidelines.

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