Delayed onset of the jarisch-herxheimer reaction in doxycycline-treated disease: A case report and review of its histopathology and implications for pathogenesis

American Journal of Dermatopathology

Volumn 37, Issue 6, 2015, Pages e68-e74

  Kadam, Pooja ^a   Gregory, Neal A ^b   Zelger, Bernhard ^c   Carlson, J Andrew ^a,b  

^a ALBANY MEDICAL COLLEGE   (United States)

^b Upper Hudson Valley Dermatology   (United States)

^c INNSBRUCK MEDICAL UNIVERSITY   (Austria)

Author keywords

delayed type hypersensitivity reaction; humoral immunity; immunohistochemistry; Jarisch Herxheimer reaction; Lyme disease; lymphostasis; spirochete

Indexed keywords

DOXYCYCLINE; ITRACONAZOLE; ANTIINFECTIVE AGENT;

ADULT; ALCOHOL CONSUMPTION; ALLERGIC REACTION; ARTICLE; BLOOD CELL COUNT; BORRELIA BURGDORFERI; CASE REPORT; DIFFERENTIAL DIAGNOSIS; DISEASE COURSE; DRUG ERUPTION; DRUG WITHDRAWAL; ERYTHEMA; ERYTHEMA CHRONICUM MIGRANS; FATIGUE; FEMALE; GINGIVAL ERYTHEMA; HERXHEIMER REACTION; HISTOPATHOLOGY; HUMAN; HUMAN TISSUE; IMMUNOHISTOCHEMISTRY; INTERCELLULAR SPACE; IRRITANT DERMATITIS; JOINT SWELLING; LYME DISEASE; MIDDLE AGED; MYALGIA; MYCOSIS; PRIORITY JOURNAL; PUNCH BIOPSY; SINGLE DRUG DOSE; TREPONEMA PALLIDUM; WEAKNESS; COMPLICATION; DRUG ERUPTIONS; PATHOLOGY;

ANTI-BACTERIAL AGENTS; DOXYCYCLINE; DRUG ERUPTIONS; ERYTHEMA CHRONICUM MIGRANS; FEMALE; HUMANS; MIDDLE AGED;

EID: 84930575908     PISSN: 01931091     EISSN: 15330311     Source Type: Journal    
DOI: 10.1097/DAD.0000000000000093     Document Type: Article

References (38)

1. Belum GR, Belum VR, Chaitanya Arudra SK, et al. The Jarisch-Herxheimer reaction: revisited. Travel Med Infect Dis. 2013;11: 231-237. PubMed PMID: 23632012.
2. Pound MW, May DB. Proposed mechanisms and preventative options of Jarisch-Herxheimer reactions. J Clin Pharm Ther. 2005;30:291-295. PubMed PMID: 15896248.
3. Guerrier G, D'Ortenzio E. The Jarisch-Herxheimer reaction leptospirosis: a systematic review. PloS One. 2013;8:e59266. PubMed PMID: 23555644. Pubmed Central PMCID: 3608636.
4. Monsel G, Canestri A, Caumes E. Antibiotherapy for early localized Lyme disease [in French]. Med Mal Infect. 2007;37:463-472. PubMed PMID: 17412541.
5. Weber K, Neubert U, Thurmayr R. Antibiotic therapy in early erythema migrans disease and related disorders. Zentralbl Bakteriol Mikrobiol Hyg A. 1987;263:377-388. PubMed PMID: 3591091.
6. Herxheimer K, Krause D. Ueber eine bei Syphilitischen vorkommende Quecksilberreaktion. Dtsch Med Wochenschr. 1902;28:895.
7. Pinkus F. Ueber die hyperämischen Hautreaktionen nach Salvarsan, namentlich Früreaktioinen. Dermat Ztschr. 1911;18:672.
8. Frieboes W. Beiting zur Klinik und Histopathologie der lokalen Salvarsan-Hautrektion. Dermat Ztschr. 1911;18:1044.
9. Lloyd V. Comment by Kolmer J, quoted in the Jarisch-Herxheimer reaction. Br J Vener Dis. 1945;21:42.
10. Sheldon WH, Heyman A. Morphologic changes in syphilitic lesions during the Jarisch-Herxheimer reaction. Am J Syph Gonorrhea Vener Dis. 1949;33:213-224. PubMed PMID: 18121294.
11. Rosen T, Rubin H, Ellner K, et al. Vesicular Jarisch-Herxheimer reaction. Arch Dermatol. 1989;125:77-81. PubMed PMID: 2642683.
12. Chung G, Kantor GR, Whipple S. Tertiary syphilis of the face. J Am Acad Dermatol. 1991;24(5 pt 2):832-835. PubMed PMID: 2050849.
13. Singh G, Jalpota Y. Jarisch-Herxheimer reaction in early syphilis. Indian J Sex Transm Dis. 1992;13:57-59.
14. Aronson IK, Soltani K, Brickman F. Jarisch-Herxheimer reaction in complement-depleted rabbits. Histological and immunofluorescence studies of early cutaneous lesions. Br J Vener Dis. 1981;57:226-231. PubMed PMID: 7023600. Pubmed Central PMCID: 1045929.
15. Sheldon WH, Heyman A, Evans LD. The production of Herxheimer reactions by injection of immune serum in rabbits with experimental syphilis. Am J Syph Gonorrhea Vener Dis. 1951;35:405-410. PubMed PMID: 14878087.
16. Sheldon WH, Heyman A, Evans LD. Production of Herxheimer-like reactions in rabbits with spirillum minus infections by administration of penicillin or immune serum. Am J Syph Gonorrhea Vener Dis. 1951;35:411-415. PubMed PMID: 14878088.
17. Paul J, Schaller J, Rohwedder A, et al. Treated Whipple disease with erythema nodosum leprosum-like lesions: cutaneous PAS-positive macrophages slowly decrease with time and are associated with lymphangiectases: a case report. Am J Dermatopathol. 2012;34:182-187. PubMed PMID: 22123268.
18. Eisendle K, Grabner T, Zelger B. Focus floating microscopy: "gold standard" for cutaneous borreliosis? Am J Clin Pathol. 2007;127: 213-222. PubMed PMID: 17210530. Eng.
19. Müller H, Eisendle K, Brauninger W, et al. Comparative analysis of immunohistochemistry, polymerase chain reaction and focus-floating microscopy for the detection of Treponema pallidum in mucocutaneous lesions of primary, secondary and tertiary syphilis [published online ahead of print March 18, 2011]. Br J Dermatol. 2011. PubMed PMID: 21410678. Eng.
20. Nadelman RB, Luger SW, Frank E, et al. Comparison of cefuroxime axetil and doxycycline in the treatment of early Lyme disease. Ann Intern Med. 1992;117:273-280. PubMed PMID: 1637021.
21. Luger SW, Paparone P, Wormser GP, et al. Comparison of cefuroxime axetil and doxycycline in treatment of patients with early Lyme disease associated with erythema migrans. Antimicrob Agents Chemother. 1995; 39:661-667. PubMed PMID: 7793869. Pubmed Central PMCID: 162601.
22. Nizic T, Velikanje E, Ruzic-Sabljic E, et al. Solitary erythema migrans in children: comparison of treatment with clarithromycin and amoxicillin. Wien Klin Wochenschr. 2012;124:427-433. PubMed PMID: 22760494.
23. Steere AC, Hutchinson GJ, Rahn DW, et al. Treatment of the early manifestations of Lyme disease. Ann Intern Med. 1983;99:22-26. PubMed PMID: 6407378.
24. Miller WM, Gorini F, Botelho G, et al. Jarisch-Herxheimer reaction among syphilis patients in Rio de Janeiro, Brazil. Int J STD AIDS. 2010;21:806-809. PubMed PMID: 21297087.
25. Hashimoto T, Akata S, Park J, et al. High-resolution computed tomography findings in a case of severe leptospira infection (Weil disease) complicated with Jarisch-Herxheimer reaction. J Thorac Imaging. 2012;27:W24-W26. PubMed PMID: 22071677.
26. Sell S. Immunology, Immunopathology, and Immunity. 6th ed. Sell S, ed. Washington, DC: American Society for Microbiology; 2001.
27. Carlson JA, Dabiri G, Cribier B, et al. The immunopathobiology of syphilis: the manifestations and course of syphilis are determined by the level of delayed-type hypersensitivity. Am J Dermatopathol. 2011; 33:433-460. PubMed PMID: 21694502. Eng.
28. Aronson IK, Soltani K. The enigma of the pathogenesis of the Jarisch-Herxheimer reaction. Br J Vener Dis. 1976;52:313-315. PubMed PMID: 791455. Pubmed Central PMCID: 1045291.
29. Yang CJ, Lee NY, Lin YH, et al. Jarisch-Herxheimer reaction after penicillin therapy among patients with syphilis in the era of the HIV infection epidemic: incidence and risk factors. Clin Infect Dis. 2010; 51:976-979. PubMed PMID: 20825309.
30. Scott V, Clark EG. Syphilitic nephrosis as a manifestation of a renal Herxheimer reaction following penicillin therapy for early syphilis. Am J Syph Gonorrhea Vener Dis. 1946;30:463-467. PubMed PMID: 21000088.
31. Davis LE, Oyer R, Beckham JD, et al. Elevated CSF cytokines in the Jarisch-Herxheimer reaction of general paresis. JAMA Neurol. 2013;70: 1060-1064. PubMed PMID: 23732875.
32. Wright D, Cutler S, Wormser G, et al. The Jarisch-Herxheimer reaction in patients with erythema migrans. J Spirochetal Tick Borne Dis. 1996;3: 98-100.
33. Fekade D, Knox K, Hussein K, et al. Prevention of Jarisch-Herxheimer reactions by treatment with antibodies against tumor necrosis factor alpha. N Engl J Med. 1996;335:311-315. PubMed PMID: 8663853.
34. Scollard DM, Adams LB, Gillis TP, et al. The continuing challenges of leprosy. Clin Microbiol Rev. 2006;19:338-381. PubMed PMID: 16614253. Pubmed Central PMCID: 1471987. Eng.
35. Cheng VC, Ho PL, Lee RA, et al. Clinical spectrum of paradoxical deterioration during antituberculosis therapy in non-HIV-infected patients. Eur J Clin Microbiol Infect Dis. 2002;21:803-809. PubMed PMID: 12461590. Eng.
36. Moraes MO, Sampaio EP, Nery JA, et al. Sequential erythema nodosum leprosum and reversal reaction with similar lesional cytokine mRNA patterns in a borderline leprosy patient. Br J Dermatol. 2001; 144:175-181. PubMed PMID: 11167702. Eng.
37. Paul J, Carlson JA. Lymphangiectases are common underlying warts and in normal peritumoral skin: histologic evidence of decreased immune surveillance [published online ahead of print 15, February, 2011]. Am J Dermatopathol. 2011. PubMed PMID: 21317613. Eng.
38. Zinkernagel RM. Antiinfection immunity and autoimmunity. Ann N Y Acad Sci. 2002;958:3-6. PubMed PMID: 12021079. Eng.