STI: Jarisch-Herxheimer reaction: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · STI: Jarisch-Herxheimer reaction

Sample item

Within hours of the first penicillin injection for secondary syphilis, a patient develops fever, chills, myalgia and exacerbation of the rash. What is this reaction?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Jarisch-Herxheimer reaction

The Jarisch-Herxheimer reaction follows release of treponemal products and cytokines after antibiotic treatment, typically within 24 hours. It is self-limited and managed with antipyretics, and the antibiotic is continued.

Option by option

  • A. Stevens-Johnson syndrome

    SJS shows mucosal erosions and skin detachment.

  • B. Serum sickness

    Serum sickness appears after 1 to 2 weeks.

  • C. Jarisch-Herxheimer reaction (correct)

    Correct. The timing and features indicate a Jarisch-Herxheimer reaction.

  • D. Anaphylaxis

    Anaphylaxis shows urticaria, bronchospasm and hypotension within minutes.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Jarisch-Herxheimer reaction. The Jarisch-Herxheimer reaction follows release of treponemal products and cytokines after antibiotic treatment, typically within 24 hours.

Why is "Stevens-Johnson syndrome" not the answer?

SJS shows mucosal erosions and skin detachment.

Why is "Serum sickness" not the answer?

Serum sickness appears after 1 to 2 weeks.

Why is "Anaphylaxis" not the answer?

Anaphylaxis shows urticaria, bronchospasm and hypotension within minutes.

What concept does this question test?

It tests STI: Jarisch-Herxheimer reaction in Dermatology. It is self-limited and managed with antipyretics, and the antibiotic is continued.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study STI: Jarisch-Herxheimer reaction?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.