Introduction

Relapsing fever is a bacterial infection caused by the spiral-shaped Borrelia species (excluding Borrelia burgdorferi, the causative organism of Lyme disease) transmitted by lice or tick bites.

-it occurs in two forms linked to the mode of transmission and the Borrelia species involved

Louse-borne relapsing fever (LBRF): epidemic; caused by Borrelia recurrentis, transmitted by the body louse 

Tick-borne relapsing fever (TBRF): endemic; caused by multiple Borrelia species, transmitted by ticks 

Symptoms & Signs 

After a louse or tick bite, Borrelia enters the body, multiplies and produces endotoxins which affect the liver, spleen, and capillaries. 

-Abrupt onset of fever, chills, nausea, vomiting, arthralgia, headaches

rashes, hepatomegaly, splenomegaly 

-Delirium, neurologic and psychological abnormalities

-Attacks terminates abruptly after 3-10 days 

-Relapse occurs after an interval of 1-2 weeks 

-Three to ten relapses may occur before recovery

Diagnosis 

Thin or thick blood smears stained with Wright or Giemsa stain reveal large, loosely coiled spirochetes; PCR techniques, serology 

Treatment 

Procaine Penicillin G, tetracyclines, erythromycin