Herxheimer

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In this case report, we describe a 60-year-old man who presented with headaches for 1 year and mild confusion for 3 weeks and was initially diagnosed as having a cerebral tumor on the basis of finding a round lesion in the right lenticular nucleus with ring enhancement on gadolinium-enhanced T1-weighted brain magnetic resonance imaging. However, the discovery of positive serology for Treponema pallidum infection on routine tests on admission prompted analysis of cerebrospinal fluid, which was also positive on Treponema pallidum hemagglutination (TPHA), rapid plasma reagin (RPR), and treponemal antibody absorption (FTA-ABS) tests...

Background: The literature suggests that the Jarisch-Herxheimer (J-H) reaction following antimicrobial treatment of syphilis is common and may precipitate uterine activity. Local practice is to transfer syphilitic parturients beyond gestational age of viability from rural locations to a tertiary care centre for treatment. Study objectives were to delineate local incidence and risk factors for the J-H reaction among pregnant women receiving treatment for syphilis. Methods: A retrospective chart review was conducted on pregnant women diagnosed with syphilis and treated during pregnancy at a tertiary care centre between 2012 and 2018...

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Malignant syphilis (MS) is a rare, atypical manifestation of secondary syphilis. Ulcerative lesions should be suspected as MS when found with supporting microscopic morphology, a high syphilis serology titer test, a Jarisch-Herxheimer reaction (JHR), and rapid disease resolution. To date, there is no specific recommendation for treatment for MS. A 24-year-old HIV-positive MSM patient with a CD4 count of 470 cells/µl presented with a chief complaint of necrotic, ulcerative lesions and oyster shell-like surface plaques on his face, trunk, groin, and extremities...

Leptospirosis is an ubiquitous zoonosis with significant morbidity and mortality. Approximately 10 percent of human infections evolve into a severe form, with a sepsis-like disease, multiorgan failure, and significant mortality rate. The cornerstone of treatment of severe disease is antibiotic therapy, with the aims of preventing complications, reducing the duration of disease, and ultimately reducing mortality. The initiation of antibiotic chemotherapy can precipitate a febrile inflammatory reaction, also known as a Jarisch-Herxheimer reaction...

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Although echinococcosis is a common parasitic disease endemic to Africa, ocular echinococcosis is rare. We present a case of intraocular echinococcosis in a HIV-infected patient. A 38-year-old South African HIV-infected woman presented to a district-level hospital in Kwa-Zulu Natal on 10 March 2020. Her main presenting complaint was that of progressive, painless, bilateral visual loss. A B-ultrasonography scan revealed tractional retinal detachment on the right eye, while the left eye had tractional bands with a 'double-walled' cystic cavity causing retinal traction...

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An effort is made to substantiate that vascular abnormalities (fluid dynamic/mechanical properties) could be restored to homeostasis by an appropriate hypnotic trance. Clinical Background:Sepsis: Clinical data/Record(observation): decreased capillary density ref Fig 4 c., PMID: 34055944, hypovolemia, endothelial dysfunction, increased WBC accumulation, thrombi deposition, altered CCP, NFP gradient, shunting, degradation of endothelial glycocalyx, vascular hyper permeability (PMID: 23566729; PMID: 20179590; PMID: 24067428), as an indicator of sepsis progress to septic shock...

Problem Statement and Rationale: Unpredictable nature of fluid dynamic/mechanical properties of circulation, subsequent to ERP-EGDT, in part attributed to multiple classes of antibiotics (met. Breakdown products, adducts), administered across the globe Tx, sepsis with CC, MCC, DDx, Rx, PX., impeded the TM of ZoO @ LPE vortices, control of VKVS, BLS on ISP surpassing GCS 3-8 to ihm. To obtain a reasonable understanding of the factors governing, antimicrobial stewardship (AS), and STIC, which are intrinsically strewn across the globe, we have completed a review focused on its effective utilization in TM of ERP-EGDT, Tx severe sepsis: Part I: Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data; Approved Guideline-4ed...

Clinical Focus: An effort is made to delineate the underlying hemodynamic alteration in the usual care group registered with 5 patients @ 100% ihm; vs the sepsis protocol cohort with 11 patients @ 90.05% ihm with a median hospital stay of 5 days (Ref: Fig 3. Risk of ihm by subgroup for patients treated with the sepsis protocol vs usual care; p1239) NCT01663701, (PMID: 28973227). The goal is to explore whether there is any temporal link between neuropsychiatric indices and SSSP-2. Hypothesis: The AR clPr causing STD, with CCI, Tx with antibiotics (PMID: 31331661; NBK557820; PMID: 32491752), released toxins exacerbating the vortices formation in fluid bolus induced fluid volume expansion by Flow-Induced Vibration (FIV) (Oscillating flow) (VIV)...

The number of reported cases of syphilis has been increasing for years. The sexually transmitted disease is caused by the spirochete Treponema pallidum subspecies pallidum and progresses in different stages. Symptoms in the ENT area can occur in all stages. This means that a syphilis infection should always be considered by the ENT doctor as a differential diagnosis if the symptoms are suitable. Thus, with increasing oral sexual intercourse, the primary effect/hard chancre is more often observed in the oral cavity...

The number of syphilis patients has significantly increased recently in Japan and worldwide. Previous reports, even in large institutions, may not accurately reflect the current situation in urological clinics. We therefore collected data from 11 urological clinics in Hyogo Prefecture, Japan over a 2-year period subdivided into 1) August 2016 to July 2017 and 2) August 2017 to July 2018 to compare changes in syphilis consults. We analyzed the patient data including a rapid plasma reagin test (RPR), Treponema pallidum (TP) antibody, clinical stage, therapy, and presence of Jarisch-Herxheimer reaction...

Malignant syphilis (MS) is a rare form of secondary syphilis with grotesque skin lesions, systemic manifestation and life-threatening complications. This article presents a case of MS in an immunocompetent 41-year-old female, who initially manifested with a generalized nonpruritic erythematous rash and systemic symptoms. She was mistreated for generalized impetigo and hepatitis attributed to chronic alcoholism. After partial recovery and a 3-month latent period, she developed infiltrated plaques with crusts on the trunk, head and neck; pharyngitis and laryngeal lesions; generalized lymphadenopathy and nonspecific systemic symptoms...

Whipple's disease is a rare chronic infection caused by the actinomycete Tropheryma whipplei. Patients commonly present with gastrointestinal symptoms. We present a case of classic Whipple's disease complicated by a probable Jarisch-Herxheimer reaction following the initiation of ceftriaxone treatment.

Paradoxical reaction (also known as Jarisch-Herxheimer reaction) is a self-limited response to endotoxin released from dead bacteria after starting treatment and is characterized by constitutional symptoms such as fever, headache, dizziness and exacerbation of cutaneous lesions. We report a rare case of a 55-year-old gentleman, on peritoneal dialysis, who developed fever, dizziness and cloudy dialysate after starting anti-tuberculous treatment for disseminated tuberculous lymphadenitis. He was started on antibiotics for suspected peritoneal dialysis peritonitis and anti-tuberculosis treatment was continued...

Of 39 pregnant women at ≥20 weeks' gestation treated with benzathine penicillin G for infectious syphilis, we identified only 2 mild Jarisch-Herxheimer reactions. There were no immediate fetal sequelae. Data from our study do not support the recommendation for routine admission for the treatment of infectious syphilis in late pregnancy.

BACKGROUND: The Jarisch-Herxheimer reaction (JHR) is an inflammatory reaction that can occur after treatment for syphilis. The mechanism of JHR is unknown. The level of C-reactive protein (CRP) increases during infection and inflammation. We hypothesized that CRP may be involved in the JHR in syphilitic patients at initial syphilis infection and also through interactions with benzathine penicillin-induced phagocytosis. METHODS: This prospective cohort study enrolled syphilitic adult patients with/without JHR between July 2018 and October 2020...

The overall failure rate of standard therapeutic options for late/chronic/persistent borreliosis emphasizes the need for novel therapeutic strategies. In this report, we are presenting a novel therapeutic option based on a new technology, Induced Native Phage Therapy (INPT; PhagenCorp, LLC, Sarasota, FL), and its ability to facilitate the elimination of infection more rapidly, efficiently, and with less harm to the patient than conventional treatments. Borrelia species in the environment are themselves always infected by their own type of Borrelia bacteriophages...