This scanning electron micrograph (SEM) depicts a number of Leptospira sp. bacteria atop a 0.1. µm polycarbonate filter. By CDC/ Rob Weyant.
Initiation of chemotherapy in spirochetal diseases may precipitate a febrile inflammatory reaction, known as the JarischHerxheimer reaction (JHR), originally described in patients with syphilis receiving mercury treatment.
This reaction is characterised by an acute inflammatory response associated with the release of large amounts of cytokines, resulting from clearance of spirochetes from the circulation.
Prevalence, clinical manifestations and outcome of JHR have been well studied in syphilis, Lyme disease, tick-born relapsing fever and louse-born relapsing fever.
Con información de: Guerrier, G., & D’Ortenzio, E. (2013). The Jarisch Herxheimer reaction in leptospirosis: a systematic review. PloS one, 8(3), e59266. doi:10.1371/journal.pone.0059266