Local incidence of Jarisch–Herxheimer reaction in pregnancy following penicillin treatment for syphilis: A case series
Bibliographic record
Abstract
Background: The literature suggests that the Jarisch-Herxheimer (J-H) reaction following antimicrobial treatment of syphilis is common and may precipitate uterine activity. Local practice is to transfer syphilitic parturients beyond gestational age of viability from rural locations to a tertiary care centre for treatment. Study objectives were to delineate local incidence and risk factors for the J-H reaction among pregnant women receiving treatment for syphilis. Methods: A retrospective chart review was conducted on pregnant women diagnosed with syphilis and treated during pregnancy at a tertiary care centre between 2012 and 2018. J-H reaction was defined as having ≥1 of the following symptoms within 24 hours of antibiotic treatment: fever (temperature ≥38°C), clinical description of a painful or itchy skin lesion, headache, hypotension (systolic blood pressure <90 mmHg), uterine contractions, or fetal heart rate decelerations. Descriptive statistical analysis was performed with mean and median used as measures of central tendency for continuous and categorical data, respectively. Results: Fifty-eight charts were eligible for inclusion. Mean maternal age was 25.1 (SD 5.6) years, and mean gestational age was 20.4 (SD 9.5) weeks when syphilis was diagnosed. One patient (1/58, 1.7%) met J-H reaction criteria. Mean gestational age at delivery was 37.1 (SD 3.4) weeks. One stillbirth (1.7%) was identified. Conclusions: The J-H reaction is less common at our centre than the literature suggests. Further research is important to identify risk factors associated with J-H reaction to optimize resource allocation in the context of treatment of syphilis during pregnancy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".