Unique manifestations and risk factors of Jarisch-Herxheimer reaction during treatment of child congenital syphilis.

Abstract:

OBJECTIVES:The objective of this retrospective study was to summarise the clinical manifestations of, and to analyse the incidence and risk factors of, Jarisch-Herxheimer reaction (JHR) during the treatment of children with symptomatic congenital syphilis. METHODS:Clinical data of 60 children with clinically and laboratory diagnosed congenital syphilis, hospitalised in Beijing Ditan Hospital between January 2010 and November 2015, were collected and analysed. RESULTS:A total of 11 patients with congenital syphilis (11/60, 18.3%) developed JHR. JHR occurred in 1-6 hour after the first dose of penicillin. Common clinical manifestations included fever (11/11, 100%), irritability (11/11, 100%), rapid pulse and breathing (11/11, 100%), exacerbation of existing rash (5/11, 45.6%) and chills (3/11, 27.3%). Of the 11 patients who developed JHR, 9 patients (9/11, 81.8%) had bone syphilis, 10 (10/11, 90.9%) had more than three organs affected by syphilis and 10 (10/11, 90.9%) had a high plasma concentration of rapid plasma reagin (RPR) (≥1:256); these percentages were significantly higher than in patients who had not developed JHR (p<0.05), suggesting that the occurrence of JHR was related to bone syphilis, having more than three organs affected by syphilis and a high plasma concentration of RPR. CONCLUSIONS:Clinicians should be familiar with the risk factors for this reaction and its common clinical manifestations.

journal_name

Sex Transm Infect

authors

Wang C,He S,Yang H,Liu Y,Zhao Y,Pang L

doi

10.1136/sextrans-2016-053083

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

562-564

issue

8

eissn

1368-4973

issn

1472-3263

pii

sextrans-2016-053083

journal_volume

94

pub_type

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