35. What is a Herxheimer reaction?

Jarisch-Herxheimer's reactions often occur during antibiotic therapy for spirochetal infections and may be fatal in some cases. A 'herx' occurs when the spirochetes die off and produce toxins. Symptoms may become much worse during the reaction. Due to the replication cycle of the spirochete, treatment for Lyme should continue for several months after all Jarisch-Herxheimer reactions have ceased and all symptoms have cleared or the patient is likely to relapse.

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