Mazzotti reaction
The Mazzotti reaction, first described in 1948, is a symptom complex seen in patients after undergoing treatment of onchocerciasis with the medication diethylcarbamazine (DEC). Mazzotti reactions can be life-threatening, and are characterized by fever, urticaria, swollen and tender lymph nodes, tachycardia, hypotension, arthralgias, oedema, and abdominal pain that occur within seven days of treatment of microfilariasis. The Mazzotti reaction correlates with intensity of infection, however there are probably multiple infection intensity-dependent mechanisms responsible for mediating this complex reaction.[1]
The phenomenon is so common when DEC is used for the treatment of onchocerciasis that this drug is the basis of a skin patch test used to confirm that diagnosis. The drug patch is placed on the skin, and if the patient is infected with the microfilaria of O. volvulus, localized pruritus and urticaria are seen at the application site.
A case of the Mazzotti reaction has been reported after presumptive treatment of schistosomiasis and strongyloidiasis with ivermectin, praziquantel and albendazole. The patient had complete resolution of symptoms after intravenous therapy with methylprednisolone.[2]
References
- ^ Francis, H; Awadzi, K; Ottesen EA (1985). "The Mazzotti reaction following treatment of
onchocerciasis with diethylcarbamazine: clinical severity as a function of
infection intensity". Am J Trop Med Hyg. 34 (3): 529–36. PMID 4003668.
{{cite journal}}: line feed character in|title=at position 46 (help)CS1 maint: multiple names: authors list (link) - ^ Olson, Bradley G. MD (May 2006). "Mazzotti Reaction After Presumptive Treatment for Schistosomiasis and Strongyloidiasis in A Liberian Refugee". Pediatric Infectious Disease Journal. 25 (5): 466–468. doi:10.1097/01.inf.0000217415.68892.0c.
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