11/26. Can protracted relapsing fever resemble lyme disease?We report the case of a Protestant missionary who contracted tick-borne relapsing fever in 1979 while serving in the sudan. Despite tetracycline treatment, his acute illness ran a protracted course, with migratory polyarthralgias lasting approximately 10 months. Symptoms recurred in 1984 and have persisted. At regular intervals, the patient has experienced recurrent episodes of fever, generalized fatigue, bilateral upper and lower extremity muscle weakness, and asymetric large joint polyarthralgia. Indirect fluorescent antibody testing of sera demonstrated titers of 1:16 for B. burgdorferi and 1:64 for B. hermsii, and immunoblotting confirmed past exposure to relapsing fever, but not lyme disease. It is hypothesized that this individual's chronic symptoms have been related to relapsing fever, and that in certain situations or in select individuals, relapsing fever can be capable of producing a chronic clinical picture analogous to lyme disease.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
12/26. Tick-borne relapsing fever in a premature infant.relapsing fever is caused by the borrelia species of spirochetes. Louse-born epidemics of the disease may occur but the endemic disease is usually transmitted to humans by the bite of an infected tick (Ornithodorus). Transplacental infection was suggested more than 75 years ago (1) but has been rarely documented (2). We describe a case of neonatal relapsing fever where maternal infection was the probable cause of the premature delivery and infection in the infant.- - - - - - - - - - ranking = 0.66666666666667keywords = fever (Clic here for more details about this article) |
13/26. relapsing fever (borrelia) in an adolescent tourist in israel.A case of an adolescent tourist who contracted relapsing fever (borrelia) in israel is presented. travel in an infested area, a fever of irregular nature, and a strong history of tick bites are clues to diagnosis.- - - - - - - - - - ranking = 0.66666666666667keywords = fever (Clic here for more details about this article) |
14/26. Fatal-Jarisch Herxheimer reaction in a case of relapsing fever misdiagnosed as lobar pneumonia.A fatal Jarisch-Herxheimer reaction developed after treatment with high doses of penicillin in a case of lobar pneumonia caused by borrelia duttoni. Penicillin given on the first day and tetracycline on subsequent days to avoid severe Jarisch-Herxheimer reactions, has the disadvantage of a longer period of spirochetemia and hypotension as compared with tetracycline on the first day. Treatment may have contributed to the death of this patient.- - - - - - - - - - ranking = 0.44444444444444keywords = fever (Clic here for more details about this article) |
15/26. Tick-borne relapsing fever in colorado. Historical review and report of cases.Since 1915 the front range of the colorado Rocky Mountains has been postulated as a focus of endemic tick-borne relapsing fever. However, the disease has rarely been identified: only two cases have been reported in colorado since 1944. Three sporadic cases in 1977--tightly grouped geographically and temporally--prompted an epidemiologic review. Tick-borne relapsing fever should be considered in the differential diagnosis of recurrent paroxysmal fever--with or without known presence of ticks--whenever exposure in an endemic area is part of a patient's history.- - - - - - - - - - ranking = 0.77777777777778keywords = fever (Clic here for more details about this article) |
16/26. Neonatal borrelia species infection (relapsing fever).Two cases of neonatal borrelia infection occurred. The first was in a 30-hour-old Bedouin neonate who had been delivered of a febrile mother in a tent. She was admitted to the hospital on the second day of life in a good, general state. Her condition deteriorated a few hours after admission when jaundice, hepatosplenomegaly, and hemorrhage appeared. borrelia organisms were found on peripheral blood smear. The patient died 16 hours after admission. Findings from the physical examination of the mother were normal, and no borrelia organisms were seen in her blood smears. The second case was in a 15-day-old male newborn who was admitted to the hospital with severe jaundice, hepatosplenomegaly, bleeding tendency, and evidence of severe acidosis. Multiple spirochetes were found in blood and CSF smears. His clinical course was fulminant, and despite massive antibiotic treatment, he died within 24 hours of admission. Three weeks prior to delivery, the mother had had a febrile illness. Examination of the mother and her blood at the time of the illness of her son did not disclose any abnormalities.- - - - - - - - - - ranking = 0.44444444444444keywords = fever (Clic here for more details about this article) |
17/26. The spectrum of relapsing fever in the Rocky Mountains.Between 1940 and 1976, two cases of tick-borne relapsing fever were reported in colorado, but since 1977, 23 confirmed cases have occurred. All patients had fever, with a mean of 2.8 febrile episodes (range, one to six). Complications included thrombocytopenia, endophthalmitis, meningitis, abortion, in utero infection, and erythema multiforme. All treated patients were eventually cured with antibiotics, although two pregnant patients failed to be cured by their initial courses of antibiotics. Seven of 21 treated patients had Jarisch-Herxheimer reactions, three of whom required intensive care. Five of nine patients who received tetracycline at an initial dose of 5 mg/kg or more had reactions v none of four patients treated with lower doses. Possible causes of the recent increased incidence include increased physician awareness and reporting, improved diagnostic techniques, and an actual increase due to a larger population at risk. Because summertime visits to the Rocky Mountains are becoming increasingly popular, physicians elsewhere should know how to recognize and treat this condition.- - - - - - - - - - ranking = 0.66666666666667keywords = fever (Clic here for more details about this article) |
18/26. Tick borne relapsing fever imported into the United Kingdom.A case of tick borne relapsing fever contracted in cyprus and imported into england is reported. This is the first report of the diagnosis being established by finding the organism in the bone marrow.- - - - - - - - - - ranking = 0.55555555555556keywords = fever (Clic here for more details about this article) |
19/26. Tick-borne relapsing fever in the Eastern united states.Tick-borne relapsing fever is endemic in the western part of the united states, but it has not been reported east of the mississippi River. Sporadic cases have been reported in the eastern part of the united states, but travel to the West during the incubation period appeared to provide the source of infection. In the fall of 1975, a case of relapsing fever was diagnosed in Cincinnati in a child who had not traveled outside of ohio, indicating the presence of borrelia in this area. Serial serological studies indicated that B turicatae was the species involved. The occurrence of this case suggests that relapsing fever may exist in the eastern part of the united states, but its presence may not be appreciated because of the rarity of the disease and the difficulty in confirming the diagnosis.- - - - - - - - - - ranking = 0.77777777777778keywords = fever (Clic here for more details about this article) |
20/26. Detection of borrelia in acridine orange-stained blood smears by fluorescence microscopy.Tick-borne borreliosis (relapsing fever) can be an important, unsuspected cause of febrile illness. The diagnosis is generally made by identifying borrelia spirochetes in stained peripheral blood smears. Since borrelia may be difficult to detect with Romanowsky stains, an alternative method, using acridine orange (AO), was used to screen blood smears. Duplicate blood smears of seven patients were examined with the AO technique and Romanowsky stains. In all seven cases spirochetes were easily identified with the AO-stained smears compared with only five cases with Romanowsky stains. In a double-blind laboratory experiment, six of ten duplicate smears from a single patient with mild spirochetemia were positive by AO, whereas only two of ten were positive by Romanowsky stain. We concluded that the AO stain is simple, rapid and more sensitive than Romanowsky methods for detecting cases of low-level spirochetemia.- - - - - - - - - - ranking = 0.11111111111111keywords = fever (Clic here for more details about this article) |
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