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» LymeNet Flash » Questions and Discussion » Medical Questions » Diagnosing Jarisch Herxheimer Reactions(JHR) In Emergency Departments

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Author Topic: Diagnosing Jarisch Herxheimer Reactions(JHR) In Emergency Departments
Bartenderbonnie
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https://journals.lww.com/em-news/Fulltext/2019/08000/InFocus__An_Unusual_Reaction_to_Antibiotic.13.aspx

The reported incidence of JHR in the Emergency room departments does not seem to correlate with most physicians clinical experience, and these authors believe that the condition often goes unrecognized or is under-reported.

It can be rather puzzling if you have not seem this reaction before-patients appear quite ill. Syphillis is the leading spirochetal infection given rise to JHR, occurring in 50 to 90 percent of patients, but it has also been reported in 15 to 20 percent of those treating Lyme disease.

Curiously and with no obvious reason, ER physicians do not seem to report anywhere near these numbers.

Those affected can appear quite ill, presenting with;

Fever
Chills
Headache
Tachycardia
Vasodilation
Hypotension
Dizziness
Facial flushing
Intensification of skin rashes

It is prudent to warn patients about a JHR but that usually doesn't happen because it is so unfamiliar to most ER Department Physicians.

(I guess this is the closest we'll get to an apology for being treated so HORRIBLY when we go to the E.R.)

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