Louse Borne Relapsing Fever (LBRF): Mortality and Frequency of Jarisch-Herxheimer Reaction

作者：Zein Ahmed Zein · 发表于：Journal of the Royal Society of Health · 年份：1987 · DOI：10.1177/146642408710700410 · 被引用次数：16 · 研究领域：Viral Infections and Vectors、Rabies epidemiology and control、Vector-borne infectious diseases

The charts of 132 louse-borne relapsing fever (LBRF) patients admitted to a teaching and provincial hospital in Northwestern Ethiopia covering the period 1970-1985 were analysed. Of the 83 males (62.9%) and 49 (37.1%) females, there were 97 patients treated with varying doses of intramuscular procaine penicillin (100,000-600,000 u) as well as a group of 35 patients treated with single or multiple doses of tetracycline. The average age of tetracycline-treated and penicillin-treated groups was similar, but 65.7% of the former group were above 20 years of age while 51.6% of the latter group were above 20 years of age. The overall rate of the Jarisch-Herxheimer (J-HR) reaction was 21.2%. The corresponding rates in penicillin- and tetracycline-treated groups were 24.7% and 11.4% respectively. Although the frequency of the J-HR reaction is twice as large in the penicillin-treated group as compared with the tetracycline- treated group, the difference is not statistically significant (P>0.05). Similarly the overall death rate following antibiotic treatment was 3.8%. In terms of the J-HR reaction, there were more deaths in the penicillin-treated group (4.1 %), with 2.8% in the tetracycline group. In terms of the frequency as well as mortality from the J-HR reaction, it appeared that penicillin had no therapeutic advantage over tetracycline, and the latter was associated with less frequent J-HR reaction and death. These findings are in contrast to the preference for penicillin in the t...