Jarisch-Herxheimer reaction in a patient with leptospirosis

In this case report, a 37-year-old female was admitted to hospital with fever and muscle pain two days after returning from Mauritius. Approximately two hours after first administration of intravenous ceftriaxone she suddenly developed respiratory and circulatory failure. Anaphylaxis and pulmonary embolism were considered and excluded. Initially she was treated as having sepsis and required respiratory and vasopressor support. She ended up testing positive for leptospirosis and it was concluded that the respiratory and circulatory failure was a Jarisch-Herxheimer reaction.