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Secondary Syphilis with Jarisch-Herxheimer Reaction
Chang-Long Tai, Hsin-Su Yu, Tsu-Chieh Shen, Gwo-Shing Chen
Dermatol Sinica 8: 15-22, 1990

A 34-year-old male patient has had two erythematous flattn plapues on face and many reddish maculopapules on upper trunk which developed about 4 months after extramarital sexual exposure.Clinical course, biopsy findings and strong positive VDRL & TPHA disclosed a picture of "secondary syphilis".After the initial IM injection of 2.4 million units of benzathine penicillin G, generalized rose-red macules developed 3 hours later. Concurrent mild fever, headache & myalgia were also noted. The symptoms subsided within 24 hours. The above clinical & pathological changes are compatible with "Jarisch-Herxheimer reaction (JHR)" originally described by Jarisch in 1895 and Herxheimer & Kraus in 1902.The pathophysiologic changes and pathogenesis of this reaction are reviewed. In addition, differential diagnosis betwen JHR penicillin allergy reaction is discussed.

   
   
 
 
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