Elevated Troponin and Jarisch-Herxheimer Reaction in Tick-Borne Relapsing Fever: A Case Report

Figure 2

Time course of Jarisch-Herxheimer reaction (J-HR) in relapsing fever. Antimicrobial therapy was started at time 0. Symptoms of rapid decrease in temperature, hypotension, and thrombocytopenia correlated with peripheral blood spirochete clearance (pattern). Sepsis resulted in elevated serum cardiac troponin without acute coronary syndrome at 36 and 48 hours compared to time 0.