June 1983

Jarisch-Herxheimer Reaction in Meningococcal Meningitis

Author Affiliations

Baragwanath Hospital and University of Witwatersrand; Sabax Laboratories Johannesburg, Republic of South Africa

Am J Dis Child. 1983;137(6):599. doi:10.1001/archpedi.1983.02140320075018

The Jarisch-Herxheimer reaction, characterized by high fever and chills followed by hypotension and sweating, is a recognized complication of treatment of spirochetal infections, such as borreliosis and syphilis, and of bacterial infections, such as brucellosis and tularemia.1 We report a case of this reaction developing during treatment of meningococcal meningitis.

Endotoxin Assay.—Plasma endotoxin levels were determined by the Limulus amebocyte lysate test.2 Briefly, plasma was incubated with lysate, the protein precipitate was measured by relative light scatter, and this was compared graphically with that produced by endotoxin of Escherichia coli 055:B5.

Report of a Case.—A 9-year-old girl was admitted to Baragwanath Hospital, Johannesburg, Republic of South Africa, on Sept 23, 1981, with a history of fever and confusion beginning on the previous day. Examination showed that she had a temperature of 38.2 °C, a pulse rate of 110 beats per minute, and a BP of 120/70