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Unique manifestations and risk factors of Jarisch–Herxheimer reaction during treatment of child congenital syphilis
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  • Published on: 28 January 2019
    Jarisch–Herxheimer reaction during treatment of congenital syphilis
    • Naveen Kumar Kansal, Dermatology Faculty Department of Dermatology, AIIMS, Rishikesh, India
    • Other Contributors:
      • Atreyo Chakraborty, Dermatology Resident

    Sir,

    We read with interest the informative Short Report by Wang et al. about Jarisch–Herxheimer reaction during therapy of congenital syphilis [1] and wish to make a few comments:

    1. The authors included in their review all patients hospitalized between 1 January 2010 to 31 November 2015. However, no such date like 31 November 2015 actually exists.

    2. Authors state that 'rapid pulse and breathing' were present in all 11/11 patients of Jarisch–Herxheimer reaction. However, they have not stated the age of these patients in the study. 'Pulse and breathing' are age-dependent variables, and in neonates pulse rate may be up to 120 to 160 beats per minute, and breathing up to 40 to 60 breaths per minute. Therefore, it is important to see how many of the Jarisch–Herxheimer reaction cases were neonates as in many of these case, pulse and respiratory may be within normal range.

    3. The recommended duration of treatment for congenital syphilis is 10 days and not 14 days as followed in this study [2].

    References:

    1. Wang C, He S, Yang H, Liu Y, Zhao Y, Pang L. Unique manifestations and risk factors of Jarisch-Herxheimer reaction during treatment of child congenital syphilis. Sex Transm Infect. 2018 Dec;94(8):562-564.

    2. CDC 2015 Sexually Transmitted Diseases Treatment Guidelines. Congenital syphilis. Available at https://www.cdc.gov/std/tg2015/congenital.htm...

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    Conflict of Interest:
    None declared.