Doxycycline
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Recurrent Jarisch-Herxheimer reaction: case report A 36-year-old man experienced recurrent JarischHerxheimer reactions while receiving doxycycline for pneumonia. The man, who had been treated initially with a third generation cephalosporin and cinolone, was hospitalised with adult respiratory distress syndrome and initiated on doxycycline [dosage not stated] aswell. A few hours after the first dose of doxycycline [time to reaction onset not clearly stated], he experienced an acute rise in temperature, with tachycardia, tachypnoea, hypoxia, hypotension and a temporary deterioration of his chest x-ray. This lasted 6 hours, and was later identified as a Jarisch-Herxheimer reaction. He subsequently suffered this reaction three more times. During these episodes, the man was given haemodynamic support and transient high mixtures of oxygen. Insulin was administered to maintain blood glucose levels. Tests for antibodies against Coxiella burnetii showed acute Q fever infection. Thirty-two days after his admission, he was discharged [outcome not stated]. Author comment: "[Jarisch-Herxheimer reaction] is extremely rare and usually associated with the antibiotic treatment of certain bacterial infections but extremely rarely is presented during the course of treatment for Coxiella burnetii." Aloizos S, et al. Recurrent Jarisch-Herxheimer reaction in a patient with Q fever pneumonia: a case report. Cases Journal 1: [10 pages], No. 360, 29 Nov 2008. 801124917 Available from: URL: http://www.casesjournal.com - Greece
0114-9954/10/1232-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 13 Dec 2008 No. 1232
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