Mazzotti reaction
A life-threatening symptom complex after nematode treatment.
Wikipedia / Wikimedia Commons
The Mazzotti reaction is a symptom complex first described in 1948, observed in patients undergoing treatment for nematode infestation, particularly with the medication diethylcarbamazine (DEC). It is characterized by fever, urticaria, swollen and tender lymph nodes, tachycardia, hypotension, arthralgias, oedema, and abdominal pain occurring within seven days of treatment for microfilariasis. The reaction can be life-threatening and correlates with the intensity of infection, though multiple infection intensity-dependent mechanisms are probably responsible.
- First described
- 1948
- Associated medication
- diethylcarbamazine (DEC)
- Primary condition
- nematode infestation, especially onchocerciasis
- Symptoms
- fever, urticaria, lymph node swelling, tachycardia, hypotension, arthralgias, oedema, abdominal pain
- Onset
- within seven days of treatment
- Severity
- can be life-threatening
Reader's Guide
The Mazzotti reaction is significant because it is a common and potentially life-threatening complication of treating filarial infections, especially onchocerciasis with DEC. Its occurrence is so frequent that DEC is used in a skin patch test to confirm onchocerciasis: localized pruritus and urticaria at the application site indicate infection with O. volvulus. The reaction has also been reported after presumptive treatment of schistosomiasis and strongyloidiasis with ivermectin, praziquantel, and albendazole, with complete resolution after intravenous methylprednisolone. Understanding the Mazzotti reaction is crucial for clinicians managing parasitic infections, as it underscores the need for careful monitoring and potential corticosteroid intervention. Its correlation with infection intensity suggests that the host immune response to dying microfilariae plays a key role, though the exact mechanisms remain uncertain.
Did You Know?
- The Mazzotti reaction was first described in 1948.
- It can be life-threatening and occurs within seven days of treatment for microfilariasis.
- The reaction is so common with DEC for onchocerciasis that DEC is used in a skin patch test for diagnosis.
- A case has been reported after treatment with ivermectin, praziquantel, and albendazole for schistosomiasis and strongyloidiasis.
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