Role of Endotoxin in the Pathogenesis of Louse-borne Relapsing Fever and in the Mechanism of the Jarisch-Herxheimer Reaction Following Treatment of Louse-borne Relapsing Fever
Abstract
The roles of certain plasma proteins and endotoxin in the pathogenesis of Borrelia recurrentis infection were studied in 15 patients. Mean titers of Hageman factor, prekallikrein, and hemolytic complement were decreased at the time of admission and 2 hours after treatment during the jarisch-Herxheimer-like reaction (JHR). Serum properdin titers were decreased in 14 patients at the time of admission and in 12 patients, 2 hours after treatment. Limulus tests for endotoxin were positive in 11 patients at the time of admission and in 13 patients 2 hours after treatment. During the JHR, the frequency of elevated fibrinogen-related antigens increased from 3 patients to 12 patients. These findings indicate that plasma protein systems are activated in B. recurrentis infection and that endotoxin may have a role in both the acute illness and in the development of the JHR after treatment. To evaluate single dose antibiotic regimens in Borrelia recurrentis infection, fifty-one patients with louse-borne relapsing fever were randomly assigned either to one of the oral antibiotic regimens tetracycline 500 mg or erythromycin 500 mg or to one of the parenteral regimens tetractcline 250 mg intravenously or procain penicillin G 600,000 units intramuscularly.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 1977
- Accession Number
- ADA047935
Entities
People
- Thomas C. Butler
Organizations
- Case Western Reserve University