Zifko U, Lindner K, Wimberger D, Volc B, Grisold W
Department of Neurology, Kaiser Franz Josef Spital, Vienna, Austria.
J Neurol Neurosurg Psychiatry. 1994 Jul;57(7):865-7. doi: 10.1136/jnnp.57.7.865.
A 40 year old man presented with progressive personality changes in the previous six months. Specific serological tests for syphilis in blood and CSF were highly positive and CSF sedimentation showed signs of an inflammatory process. Ten hours after the start of penicillin treatment a severe symptomatic Jarisch-Herxheimer reaction with alteration of level of consciousness, pupillary changes, and focal neurological signs developed. Jarisch-Herxheimer reaction may occur in various settings, particularly in the treatment of syphilis. Investigation of CSF before the treatment may predict a potential risk. Corticosteroid treatment has been suggested for prevention.
一名40岁男性在过去6个月中出现进行性人格改变。血液和脑脊液中梅毒的特异性血清学检测呈强阳性，脑脊液沉降显示有炎症过程的迹象。青霉素治疗开始10小时后，出现了严重的症状性吉海反应，伴有意识水平改变、瞳孔变化和局灶性神经体征。吉海反应可能在各种情况下发生，尤其是在梅毒治疗中。治疗前对脑脊液进行检查可能预测潜在风险。有人建议使用皮质类固醇进行预防。
