赫氏反應(Jarisch–Herxheimer reaction)
Jarisch–Herxheimer reaction，是一種抗生素使病原體突然大量死亡，釋放出毒素樣產物刺激免疫系統過度反應的現象。多見於使用penicillin治療梅毒時發生。
- 抗生素：Penicillin
- 病原體：螺旋體類細菌(spirochetes)，如Borreliosis (Lyme disease and tick-borne relapsing fever), Leptospirosis, Q fever, Bartonellosis (including cat scratch disease)。
- 機轉：
1. 抗生素使大量細菌在短時間內死亡(由用藥兩小時內即會發生症況可知)
2. 死亡菌體釋出毒性物質如內毒素(endotoxin)、脂蛋白(lipoproteins)跟一些熱穩定蛋白 (heat-stable proteins)。
3. 人體無法在短時間內將這些物質排除，進而誘發過度的免疫反應、大量產生發炎反應 細胞激素(inflammatory cytokines)如TNF-α, IL-6, IL-8。
4. 這樣的發炎反應造成症狀如發熱、寒顫、低血壓、頭痛、心搏過速、換氣過度、血管 擴張、潮紅、肌肉疼痛等等。 - 治療：固醇類(Steroids)在此抗發炎的效果不佳。僅給予IV體液補充、使用鴉片類製劑如Meptazinol減輕不適。
- 預後：自限性反應(self-limiting)，毒性物質排除後症狀即消失。
參考資料:
1. 翻譯整理自維基百科
2. 圖片網址：http://laedwardswriter.com/what-is-lyme-disease
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