Jarisch-Herxheimer reaction occurs after treating syphilis. The mechanism is:
- A Penicillin allergy causing type I hypersensitivity
- B Rapid lysis of Treponema pallidum releasing lipoproteins triggering cytokine storm (TNF-α, IL-6, IL-8) ✓
- C Formation of antigen-antibody complexes causing serum sickness
- D Complement activation by penicillin
Correct answer: B. Rapid lysis of Treponema pallidum releasing lipoproteins triggering cytokine storm (TNF-α, IL-6, IL-8)
Explanation
The Jarisch-Herxheimer reaction occurs within 2–8 hours of penicillin administration for syphilis and is characterised by fever, chills, headache, myalgia and intensification of skin lesions. It is caused by rapid killing of Treponema pallidum with release of treponemal lipoproteins (particularly outer membrane proteins) that trigger macrophage activation and a systemic cytokine storm (TNF-α, IL-6, IL-8). It is not a penicillin allergy. Management is supportive; antipyretics and hydration are used. The reaction is most common in early syphilis.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.