Mazzotti Reaction: Causes, Symptoms & Treatment

Mazzotti reaction is a complex of various symptoms. This presents itself in connection with an initiated therapy. The organism reacts with fever and an allergic reaction.

What is a Mazzotti reaction?

A Mazzotti reaction is a side effect of an underlying disease. Diseases treated with drugs in the anthelmintic drug class can cause the Mazzotti reaction. They include river blindness or direct infestation of nematodes. There are different active ingredients found in the individual preparations used to treat against the nematodes. For example, the active ingredient diethylcarbamazine is one of the substances used. A side effect of this active ingredient can be a Mazzotti reaction. This manifests itself via a symptom complex of several complaints. The affected person suffers from fever as well as a general allergic reaction. Pain or skin changes may occur. In severe cases, the substance diethylcarbamazine triggers anaphylactic shock in the patient. This is a life-threatening condition that occurs due to hypersensitivity of the immune system. The Mazotti reaction was first documented by a Mexican parasitologist in 1948. The physician was a specialist in tropical diseases caused by parasites. In the course of his work, he had several patients who complained of severe symptoms after taking medicines containing the active ingredient diethylcarbamazine.

Causes

The cause of the Mazzotti reaction is thought to be the ingestion of medical preparations containing the active ingredient diethylcarbamazine. The active ingredient is found in medications that belong to the anthelmintic drug class. There is further evidence that the active ingredients ivermectin, praziquantel and albendazole can also trigger a Mazzotti reaction. The administration of the active ingredient diethylcarbamazine finds application during therapeutic treatment. This is initiated when there is an infestation of worms. In most cases, the worm disease is threadworms. The parasitic worms are widespread all over the world, multiply rapidly and can be easily transmitted. They are found at the seaside, in tropical regions and in freshwater areas. They enter the organism via raw or contaminated food and feces. Tropical nematodes are transmitted via insect bites. In the case of worm disease, there is no spontaneous healing. Therapeutic measures must be taken to ensure that the worms die off. For this reason, in the case of a Mazzotti reaction, it must be noted that the original underlying disease is treated with a different measure.

Symptoms, complaints, and signs

Symptoms of Mazzotti reaction include pain, swollen lymph nodes, fever, and skin changes. Pain manifests as headache or joint pain. The patient’s ability to move is significantly limited by the sensation of pain. Locomotion is difficult and is often avoided. The fever triggers pain in the limbs, dullness of consciousness and listlessness. There is a feeling of powerlessness and general weakness. Skin changes are manifested by edema on the skin. So-called wheals develop, which can spread over the entire body. They are associated with reddening of the skin and itching. The wheals lead to a thickening of the skin in the affected areas. In severe cases, an anaphylactic reaction occurs within 20 seconds to 20 minutes after taking a medicine containing the active ingredient diethylcarbamazine. This is a state of shock that is considered life-threatening. The patient suffers from shortness of breath as well as a feeling of heat. Circulatory shock is imminent. In this case, the blood stagnates in the organism. Taking first aid measures is necessary.

Diagnosis and course of the disease

The diagnosis is made by a physician. This person reviews the previous illness, the medications taken for it, and the current symptoms. The disease course of Mazzotti reaction is progressive and can end in a life-threatening condition if not treated.

Complications

In general, Mazzotti reaction primarily results in a very severe fever. The fever makes the affected person appear fatigued and tired, which also prevents them from actively participating in life and daily activities.The quality of life is also significantly reduced and limited by the Mazzotti reaction. Furthermore, the usual complaints of a flu or a cold occur. Patients suffer from severe headaches and pain in the joints and extremities. Likewise, the patient’s movement is restricted and pain occurs. Furthermore, those affected suffer from disturbances in consciousness and general weakness. The skin is also affected by the Mazzotti reaction, resulting in redness and itching. Furthermore, without treatment, severe shortness of breath occurs, which can also lead to a loss of consciousness. This can cause the affected person to fall and possibly injure themselves. In the case of circulatory shock, the affected person may also lose consciousness. The Mazzotti reaction can be treated with the help of medication. Complications do not usually occur. Furthermore, the life expectancy of the affected person is also not limited if treatment is successful and quick.

When should one go to the doctor?

If the affected person suffers from complaints such as fever, malaise, aching bones and joints, changes in the appearance of the skin or headaches, a doctor should be consulted. If the complaints persist or increase in intensity, a visit to the doctor is necessary. The development of edema, swelling or wheals indicate a health impairment and should be examined. Caution should be exercised in the case of skin redness and itching. If open wounds develop, sterile wound care is needed. If this cannot be adequately provided, a physician should be consulted. If there is inflammation, pain or pus formation on the wound, a visit to the doctor is required immediately. There is a risk of blood poisoning, which is potentially life-threatening for the affected person. In case of clouding of consciousness, lack of participation and drive, as well as a feeling of illness, a doctor should be consulted. Disturbances of the cardiovascular system, a general feeling of pain throughout the body, and a decrease in usual performance indicate existing irregularities. They should be clarified by a physician so that a diagnosis can be made. Shortness of breath or anxiety should be discussed with a physician at an early stage. If acute respiratory distress, loss of consciousness or circulatory shock occurs, emergency medical services should be alerted. In parallel, immediate life-saving measures must be taken to ensure the survival of the affected person.

Treatment and therapy

Treatment of Mazzotti reaction consists of immediate discontinuation of the drug containing the active ingredient diethylcarbamazine. This is followed by treatment of the individual symptoms. For headache and joint pain, analgesic medications are used. In the case of fever, in addition to the administration of medicine, measures such as rest, sufficient intake of fluids and the use of cold compresses are taken. Skin lesions such as edema are treated with antihistamines. If the Mazzotti reaction has resulted in anaphylactic shock, immediate action must be taken. The affected person is placed in a shock position. Medication is used to get the stagnant blood moving again. The functioning blood circulation leads to a removal of the ingested drug. In severe cases, intubation is performed if the patient fails to breathe or breathes too slowly. Following the Mazzotti reaction, the existing underlying disease of nematode infestation is treated with other substances from the group of anthelmintics. The consumption of raw food is avoided during the therapy. The existing hygiene measures are tightened. The patient is asked to wash his hands more often after contact with other people. The use of public restrooms is avoided whenever possible. The use of disinfectants is emphasized when going to the toilet.

Outlook and prognosis

If medical measures are taken early, the prognosis of Mazzotti reaction is favorable. Medical experts have been able to identify the active ingredient diethylcarbamazine as the triggering stimulus. Therefore, spontaneous healing occurs if medical preparations containing the named ingredient are discontinued immediately. However, the prerequisite for a rapid recovery within a few days is that discontinuation of the medicine is already carried out at the first health irregularities. In addition, the affected person needs sufficient rest and should drink plenty of fluids to optimize the healing process.If there are already disturbances such as changes in the skin appearance or complaints of the joints, the healing process is delayed. The abnormalities of the skin usually disappear completely within several months. Although the patient is also free of complaints in this case, delays must be expected. The irregularities of the joints can be supported by taking physiotherapeutic measures. Overloading should be avoided to prevent further complications. In the case of anaphylactic shock, the prognosis worsens considerably. Here, the affected person is threatened with premature death and intensive medical care is necessary. If left untreated, the course of the disease is therefore fatal in these cases. It must be taken into account that by discontinuing the medication with the active ingredient diethylcarbamazine, it is essential to take an alternative preparation. Otherwise, the primary disease cannot be treated.

Prevention

As a preventive measure, avoid taking medicines containing diethylcarbamazine when treating threadworms. Control of worm disease can be achieved with other substances in the anthelmintic drug class. There are more than ten other active substances in this classification. Depending on the disease at hand, one of the other drugs may be prescribed and taken. In addition, nematode infestation should be prevented. This is done by thoroughly cleaning raw vegetables and lettuce before eating them.

Aftercare

Mazzotti reaction is usually associated with some discomfort and complications, all of which have a very negative impact on the quality of life of the affected person. However, the condition can usually be managed well again, restoring the patient’s usual quality of life relatively quickly. Since it is an acute concomitant reaction of another underlying disease, there is no need for follow-up care in the classical sense. However, affected patients should focus on a healthy lifestyle that avoids stress and includes plenty of exercise in the fresh air. Relaxation exercises such as those practiced in yoga also help to calm the mind and increase well-being in everyday life.

Here’s what you can do yourself

If a Mazzotti reaction is suspected, the first thing to do is to inform your doctor. The most important treatment measure is discontinuation of the triggering drug. Drug treatment of individual symptoms can be supported by various self-measures and some household and natural remedies. In case of severe headache and joint pain, bed rest is recommended. In addition, gentle sedatives such as St. John’s wort or valerian can be taken. A proven alternative from homeopathy is the globule Acidum Sulfuricum, which may be taken after consulting a doctor. Fever is alleviated by means of rest, cold compresses and sufficient intake of fluids. A dehydrating diet can be used against skin changes such as edema. In addition, warm baths with soothing medicinal plants help. The immune system also needs to be supported, for example through light sport as well as gymnastic exercises and yoga. Lastly, sufferers must also change their diet and remove raw foods from the menu. In addition, hygiene measures should be tightened; regular hand washing is particularly important. Public toilets should be avoided during the acute phase of the disease. If the symptoms have not subsided after a few days, it is best to consult a physician.