Tumor Necrosis Factor and the Jarisch–Herxheimer Reaction

In certain infectious diseases, the first dose of an effective antimicrobial drug can trigger an inflammatory host response. Within an hour or two after receiving the drug, the patient abruptly experiences chills, followed by fever and sweating and worsening of preexisting symptoms and lesions. Hyperventilation and tachycardia are accompanied by hypertension, and then by a drop in blood pressure due to vasodilation and declining peripheral resistance. Usually, the reaction resolves over a period of 6 to 12 hours.The identification of this distressing and sometimes fatal phenomenon is usually credited to Jarisch and Herxheimer, each of whom described components of . . .