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The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis

OBJECTIVES: The objective of this article was to present the clinical peculiarity of the Jarisch-Herxheimer reaction (JHR) during antibiotic treatment of Lyme arthritis. MATERIAL AND METHODS: Case study presentation as a basis for discussion, literature search of PubMed database particularly in the...

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Autores principales: Nykytyuk, Svitlana, Boyarchuk, Oksana, Klymnyuk, Sergiy, Levenets, Sofiya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667941/
https://www.ncbi.nlm.nih.gov/pubmed/33227092
http://dx.doi.org/10.5114/reum.2020.99143
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author Nykytyuk, Svitlana
Boyarchuk, Oksana
Klymnyuk, Sergiy
Levenets, Sofiya
author_facet Nykytyuk, Svitlana
Boyarchuk, Oksana
Klymnyuk, Sergiy
Levenets, Sofiya
author_sort Nykytyuk, Svitlana
collection PubMed
description OBJECTIVES: The objective of this article was to present the clinical peculiarity of the Jarisch-Herxheimer reaction (JHR) during antibiotic treatment of Lyme arthritis. MATERIAL AND METHODS: Case study presentation as a basis for discussion, literature search of PubMed database particularly in the subject of combination of the JHR and Lyme borreliosis using the combination of words “Jarisch-Herxheimer reaction” and “Lyme borreliosis”, “Lyme arthritis”, “antibiotic treatment”, “generalized inflammation”, “cytokine production”, “children”, “increasing awareness”; discussion of the problem based on a clinical case and cited articles. RESULTS: The authors present a case of Lyme arthritis in a 13-year-old boy, as well as a discussion of clinical features of this complication of Lyme disease treatment as the Jarisch-Herxheimer reaction. On the 7(th) day of doxycycline treatment the patient’s condition deteriorated: a low-grade fever occurred, and severe arthralgias with intense hip, ankle and cervical spine pain and myalgias developed. Erythrocyte sedimentation rate and C-reactive protein were elevated. The Jarisch-Herxheimer reaction was diagnosed. This complication was characterized by severity, long duration and marked signs of inflammation. CONCLUSIONS: In the reviewed literature the Jarisch-Herxheimer reaction in patients with Lyme borreliosis is described more often in adults, with mild course and short duration of the disease. Based on the presented clinical picture this severe complication may also be associated with long duration and marked signs of inflammation. The authors suggest that informing health professionals about occurrence of the Jarisch-Herxheimer reaction should help physicians to distinguish it from allergic reactions or other conditions and improve treatment outcomes.
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spelling pubmed-76679412020-11-20 The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis Nykytyuk, Svitlana Boyarchuk, Oksana Klymnyuk, Sergiy Levenets, Sofiya Reumatologia Case-Based Review OBJECTIVES: The objective of this article was to present the clinical peculiarity of the Jarisch-Herxheimer reaction (JHR) during antibiotic treatment of Lyme arthritis. MATERIAL AND METHODS: Case study presentation as a basis for discussion, literature search of PubMed database particularly in the subject of combination of the JHR and Lyme borreliosis using the combination of words “Jarisch-Herxheimer reaction” and “Lyme borreliosis”, “Lyme arthritis”, “antibiotic treatment”, “generalized inflammation”, “cytokine production”, “children”, “increasing awareness”; discussion of the problem based on a clinical case and cited articles. RESULTS: The authors present a case of Lyme arthritis in a 13-year-old boy, as well as a discussion of clinical features of this complication of Lyme disease treatment as the Jarisch-Herxheimer reaction. On the 7(th) day of doxycycline treatment the patient’s condition deteriorated: a low-grade fever occurred, and severe arthralgias with intense hip, ankle and cervical spine pain and myalgias developed. Erythrocyte sedimentation rate and C-reactive protein were elevated. The Jarisch-Herxheimer reaction was diagnosed. This complication was characterized by severity, long duration and marked signs of inflammation. CONCLUSIONS: In the reviewed literature the Jarisch-Herxheimer reaction in patients with Lyme borreliosis is described more often in adults, with mild course and short duration of the disease. Based on the presented clinical picture this severe complication may also be associated with long duration and marked signs of inflammation. The authors suggest that informing health professionals about occurrence of the Jarisch-Herxheimer reaction should help physicians to distinguish it from allergic reactions or other conditions and improve treatment outcomes. Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie 2020-10-03 2020 /pmc/articles/PMC7667941/ /pubmed/33227092 http://dx.doi.org/10.5114/reum.2020.99143 Text en Copyright: © 2020 Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Case-Based Review
Nykytyuk, Svitlana
Boyarchuk, Oksana
Klymnyuk, Sergiy
Levenets, Sofiya
The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis
title The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis
title_full The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis
title_fullStr The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis
title_full_unstemmed The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis
title_short The Jarisch-Herxheimer reaction associated with doxycycline in a patient with Lyme arthritis
title_sort jarisch-herxheimer reaction associated with doxycycline in a patient with lyme arthritis
topic Case-Based Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667941/
https://www.ncbi.nlm.nih.gov/pubmed/33227092
http://dx.doi.org/10.5114/reum.2020.99143
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