Could this be an allergic reaction?

I was recently diagnosed with Lyme Disease and just started on a course of Amoxicillin for treatment.

Two hours after taking my first dose, I noticed the arthritis in my hands was getting much worse that it had it quite some time (we think Lyme is responsible for this arthritis) Right after I noticed my hands swelling, my heart rate very suddenly started racing and I felt "flushed" - what I might describe as this horrible "death is imminent" feeling. I had a shortness of breath and was certain I was going into anaphylactic shock and ran downstairs to call 911.

By the time I reached the phone (maybe 5 seconds later), however, I was completely back to normal. Still feeling fine a few hours later, I decided this was all in my head and took the next dose. Well, once again my HR and RR went through the roof (HR well over 200) within a couple of hours (stopped within a few seconds again). I took some antihistimines and told my roommate to be ready to take me to the hospial.

Well this has since happened 4 more times in the last 24 hours(never lasting more than a few seconds but very is very intense while it is happening.) What the heck is going on here?


1. Could I be having an allergic reaction to this medicine?  Wouldn't this reaction continue to progress if this were a true allergic reaction? Why little if any itching, no hives or noticeable swelling elsewhere? I did notice I felt really cold and a strange taste in my mouth.

2. My doctor said many people have a "Herheimer-like" reaction soon after starting antibiotics for Lyme - where they feel much worse before feeling better. Could that be responsible for this reaction?

I'd appreciate any thoughts you have on this.

Thanks,
Doug

[Kevin Pho, MD]

Hello - thanks for asking your question.

Please understand my limitations over the internet as I have neither met nor examined you. This information is for patient education only. Please see your personal physician for further evaluation.

The Jarisch-Herxheimer (J-H) Reaction is an increase in the symptoms of a spirochetal disease (as syphilis, Lyme disease, or relapsing fever) occurring in some persons when treatment with spirocheticidal drugs is started.  Typically, it is a transient, short-term, immunological reaction commonly seen following antibotic (antibiotic) treatment in spirochetal disease which is manifested by fever, chills, headache, myalgias (muscle pain), and exacerbations of cutaneous lesions. The incidence is 10-15% in Lyme disease.  

However, I would not completely attribute your symptoms to that.  If you are having symptoms similar to anaphylaxis (heart racing, shortness of breath, etc.) I would immediate stop the medication and try another antibiotic for the treatment Lyme disease.  With a HR over 200, this is definitely concerning and I would definitely be evaluated by a physician.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[kt33]

I was also told I experienced a herxhiemer reaction when I took antibiotic called bactrim. I had terrible pain, weekness, shaking, nodosum on my legs and (blood )immflamation factors that were off the charts.I also was told by another physician that it was serum sickness. What is the difference?
(I was given bactrim for what I thought was nosicomial UTI post cathiterization/post tubal ligation)