Two days ago I got a bicillin intramuscular shot in my buttock for (as far as I know) primary syphilis. It was extrememely painful. The pain has continued and now at 50 hours later the pain is incredible. Walking is painful and sitting is very painful. The pain is spreading. I also developed a fever, chills, and joint pain. I've researched and discovered Jarisch-Herxheimer Reaction. I have now had fever for about 30 hours. It's worse at night. I was not informed that I might have this reaction and none of the precautions for reducing pain from the injection were followed. I received an HIV test at the same time as the syphilis treatment but do not yet know the results. I understand that this is a rather strong JHR reaction. My question is, is this likely to be an indication that I'm HIV positive?

Hello,

A strong Jarish-Herxheimer Reaction (JHR) is not an indication that you are more likely to be HIV positive. The JHR is a dramatic, although usually mild, reaction that may occur with effective antibiotic treatment of syphilis. It consists of fever, chills, muscle aches, headache, increased heart rate, increased respiratory rate, increased neutrophil count and mild drop in blood pressure. The JHR occurs in approximately 50% of patients being treated for primary syphilis (90% of those with secondary syphilis and 25% of those with early latent syphilis). It's unfortunate and disappointing you were not warned about this very common side effect of syphilis treatment or how to manage the symptoms associated with JHR. I would suggest you contact the treating physician or clinic and inform them of your frightening experience!

Dr. Bob