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Sanefumi Tsuha, Tomohiro Taniguchi, Soichi Shiiki, Masashi Narita, Daniel T Leung
BACKGROUND: Leptospirosis is a zoonotic disease known to have wide-ranging clinical manifestations. Despite a number of published case series, culture-confirmed series are few and there is a paucity of data on Jarisch-Herxheimer reaction (JHR) associated with treatment of leptospirosis. Our objective was to describe the clinical and epidemiological factors associated with leptospirosis in an endemic area of Japan, with a focus on the occurrence of JHR, an often unrecognized and likely underestimated phenomenon...
October 15, 2016: Transactions of the Royal Society of Tropical Medicine and Hygiene
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Prescrire International
Danielle Bardelay, Gilles Bardelay
No abstract text is available yet for this article.
June 2016: Prescrire International
Chad Haney, Milap C Nahata
I am a 24-year-old male who was diagnosed with chronic Lyme disease after 4 years of multiple, non-specific symptoms. I have written this case as first author with my faculty mentor listed as the coauthor. The objective of this report is to highlight the experience with doxycycline treatment. In 2007, at around age 19 years, I had an acute onset of sore throat, tonsillitis, low-grade fever, stiff upper back and neck muscles, migraines and severely stiff, cracking jaw joints. This led to >24 medical visits, multitudes of tests and examinations, and exploratory surgery over the next 3 years...
2016: BMJ Case Reports
Geoff Watts
No abstract text is available yet for this article.
April 16, 2016: Lancet
Volker Fingerle, Michael Pritsch, Martin Wächtler, Gabriele Margos, Sabine Ruske, Jette Jung, Thomas Löscher, Clemens Wendtner, Andreas Wieser
A 26 year-old female patient presented to the Tropical Medicine outpatient unit of the Ludwig Maximilians-University in Munich with febrile illness after returning from Southern Africa, where she contracted a bite by a large mite-like arthropod, most likely a soft-tick. Spirochetes were detected in Giemsa stained blood smears and treatment was started with doxycycline for suspected tick-borne relapsing fever. The patient eventually recovered after developing a slight Jarisch-Herxheimer reaction during therapy...
March 2016: PLoS Neglected Tropical Diseases
Ângela Almeida, Paula Estanqueiro, Manuel Salgado
No abstract text is available yet for this article.
April 2016: Pediatric Infectious Disease Journal
Yuen Chuen Fong Raymond, Chong Sze Ling Glenda, Lim Kah Meng
UNLABELLED: Introduction Intravenous high-dose vitamin C therapy is widely used in naturopathic and integrative oncology; however, a study reviewing its effects has never been performed in Singapore. This article serves to document administration of supportive vitamin C therapy for cancer patients in Singapore. METHODS: The clinical response of 9 cancer patients of differing stages to the regular administration of large doses (25-100 g/d) of intravenous vitamin C (IVC; ascorbic acid) is outlined...
June 2016: Integrative Cancer Therapies
Tadashi Maeda, Sadako Yoshizawa, Takehisa Hirayama, Tomoo Saga, Kazuhiro Tateda, Yoshihisa Urita
A 36-year-old man presented with facial nerve palsy, hearing loss, vertigo and headache. He was initially diagnosed with Ramsay Hunt syndrome and treated with a systemic steroid and valaciclovir; however, his symptoms deteriorated. Serum rapid plasma reagin (RPR) and treponema pallidum hemagglutination tests were positive. Cerebrospinal fluid analysis revealed an elevated white blood cell count and positive RPR, confirming the diagnosis of neurosyphilis. Penicillin G (PCG) was administered, and his facial nerve function and headache improved...
2015: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Hideharu Hagiya, Kentaro Deguchi, Kiyohiro Kawada, Fumio Otsuka
We herein report a heterosexual Japanese man in his forties who had been suffering from advanced dementia and personality change for 4 years. Positive results of a serological test for syphilis, Treponema pallidum hemagglutination assay, and fluorescent treponemal antibody-absorption test of both serum and cerebral spinal fluid led to the diagnosis of neurosyphilis. Jarisch-Herxheimer reaction was seen shortly after the first dose of penicillin was administered to the patient. His cognitive function did not recover after treatment...
2015: Internal Medicine
K R Wilting, Y Stienstra, B Sinha, M Braks, D Cornish, H Grundmann
Two patients from Eritrea, recently arrived in the Netherlands, presented with fever and were investigated for malaria. Bloodfilms showed spirochetes but no blood parasites. Louse-borne relapsing fever caused by Borrelia recurrentis was diagnosed. Treatment was complicated by severe Jarisch-Herxheimer reactions in both patients. Physicians should be aware of the possibility of B. recurrentis infection in migrant populations who travel under crowded conditions, especially after passing through endemic areas such as Ethiopia and neighbouring countries...
2015: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Maja Arnež, Eva Ružić-Sabljić
BACKGROUND: Comparison of clinical efficacy and adverse effects of treatment with azithromycin and amoxicillin in children with solitary erythema migrans (EM). METHODS: Consecutive patients younger than 15 years with untreated solitary EM referred to our institution 2002-2003 were included in this unblinded prospective clinical study in which patients were alternatively treated with either azithromycin for 5 days or amoxicillin for 14 days. The efficacy of treatment of acute disease, development of minor and major manifestations of Lyme borreliosis and adverse effects of treatment were surveyed by follow-up visits during the first year after inclusion...
October 2015: Pediatric Infectious Disease Journal
C Gallardo, J Williams-Smith, K Jaton, S Asner, J-J Cheseaux, N Troillet, O Manuel, D Berthod
Leptospirosis is a zoonosis found worldwide, with an incidence that is approximately 10 times higher in the tropics than in temperate regions. The main reservoir of leptospirosis is the rat and human infection usually results from exposure to infected animal urine or tissues. Only 10% of cases are symptomatic. We present here two confirmed and two probable cases of leptospirosis in a family returning from whitewater rafting in Thailand, illustrating the wide variety of the clinical manifestations of this infection...
April 15, 2015: Revue Médicale Suisse
Hideyuki Hori, Yoshitake Sato, Tosiji Shitara
We report a rare case of congenital syphilis (CS) presenting as Jarisch-Herxheimer reaction (JHR) at birth. The mother (primigravida) presented in labor and had not received antenatal care. She was given prophylactic ampicillin 2 g i.v. on admission and delivered shortly thereafter. The male infant (2899 g) had normal vital signs, conjunctival congestion, splenohepatomegaly, and maculopapular rash with small blisters over the entire body. Serological tests on the infant and mother confirmed CS. The infant was given i...
April 2015: Pediatrics International: Official Journal of the Japan Pediatric Society
S Takamizawa, H Gomi, Y Shimizu, H Isono, T Shirokawa, M Kato
No abstract text is available yet for this article.
December 2015: QJM: Monthly Journal of the Association of Physicians
A-S Marty, P-L Cornut, H Janin-Manificat, L Perard, F Debats, C Burillon
INTRODUCTION: Syphilis, caused by Treponema pallidum agent, results in polymorphic and non-specific ocular manifestations. Early diagnosis and institution of individualized treatment play a large role in the prognosis. The increase in syphilis over the past several years requires the ophthalmologist to consider this diagnosis in the setting of any intraocular inflammatory involvement. PURPOSE: To describe epidemiological, clinical and paraclinical features and natural history of syphilitic uveitis...
March 2015: Journal Français D'ophtalmologie
Vineet Punia, Appaji Rayi, Adithya Sivaraju
Introduction. Syphilis incidence has increased in the US in the last decade. Jarisch-Herxheimer reaction (JHR) is a well-documented adverse effect of penicillin treatment in syphilis. Stroke has not been reported as part of its phenomenology. Case Report. A 57-year-old man presented with worsening memory. His minimental status examination score was 14/30. Serum RPR test was positive and VDRL test in the CSF was reactive. Within six hours of first dose of IV crystalline penicillin G, he was found to have hemineglect and difficulty moving the left leg...
2014: Case Reports in Neurological Medicine
David B Menkes, Andrew Herxheimer
BACKGROUND: Alcohol use and antidepressant prescription are prevalent in many countries, but little is known about their combined effects. OBJECTIVE: Having been surprised by selective serotonin reuptake inhibitor (SSRI) antidepressant-treated patients who became prone to pathological intoxication, we examined this association, searching for relevant literature and cases. METHODS: A detailed literature search showed little or no interaction between SSRIs and alcohol in laboratory studies, and inconsistent effects of these drugs in problem drinkers...
2014: International Journal of Risk & Safety in Medicine
Mao-Song Tsai, Chia-Jui Yang, Nan-Yao Lee, Szu-Min Hsieh, Yu-Hui Lin, Hsin-Yun Sun, Wang-Huei Sheng, Kuan-Yeh Lee, Shan-Ping Yang, Wen-Chun Liu, Pei-Ying Wu, Wen-Chien Ko, Chien-Ching Hung
INTRODUCTION: The Jarisch-Herxheimer reaction, a febrile inflammatory reaction that often occurs after the first dose of chemotherapy in spirochetal diseases, may result in deleterious effects to patients with neurosyphilis and to pregnant women. A single 2-g oral dose of azithromycin is an alternative treatment to benzathine penicillin G for early syphilis in areas with low macrolide resistance. With its potential anti-inflammatory activity, the impact of azithromycin on the incidence of the Jarisch-Herxheimer reaction in HIV-positive patients with early syphilis has rarely been investigated...
2014: Journal of the International AIDS Society
Pooja Kadam, Neal A Gregory, Bernhard Zelger, J Andrew Carlson
The Jarisch-Herxheimer reaction (JHR) is a transient inflammatory syndrome triggered hours after the start of antibiotic treatment of spirochete infections, namely syphilis. Clinically, JHR manifests as an abrupt onset of constitutional symptoms and exacerbation of cutaneous lesions that resolve without intervention. JHR's pathogenesis is unclear and it is histopathologically rarely reported. Herein, the authors report a 47-year-old woman, with solitary erythema migrans and positive Lyme disease serology, who presented for medical care 14 days after commencement of doxycycline therapy...
June 2015: American Journal of Dermatopathology
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