relapsing fever

Relapsing fever is a bacterial infection that can cause recurring episodes of fever, typically accompanied by other symptoms such as headache, muscle or joint pain, nausea, and vomiting.

Characteristics of Relapsing Fever

• Recurring Episodes: The condition is characterized by repeated episodes of high fever, which are often separated by periods of normal body temperature.
• Symptoms: Symptoms can include:
  • High fever (up to 103°F)
  • Shaking chills
  • Headache
  • Muscle or joint pain
  • Nausea and vomiting
  • Rash (in some cases)
• Duration: Episodes of fever typically last for 3-5 days, followed by periods of recovery.
• Transmission: Relapsing fever is transmitted through the bite of infected lice or ticks.

Types of Relapsing Fever

There are two main types of relapsing fever:

1. Louse-borne relapsing fever: Transmitted through the bite of infected body lice.
2. Tick-borne relapsing fever: Transmitted through the bite of infected hard ticks.

References:

• [1] Relapsing fever is a bacterial infection transmitted by a louse or tick. It is characterized by repeated episodes of fever. (Source: #2)
• [2-5] Symptoms include high fever, shaking chills, headaches, muscle or joint pain, nausea, vomiting, and possibly rash. (Sources: #4, #6, #8, #10)
• [6] Episodes of fever are typically separated by periods of normal body temperature. (Source: #6)
• [7] Hard tick relapsing fever is a term used to differentiate infection with relapsing fever bacteria transmitted by hard ticks. (Source: #7)
• [9] Relapsing fever is characterized by recurring episodes of fever and nonspecific symptoms such as headache, myalgia, arthralgia, shaking chills, and abdominal pain. (Source: #9)

Relapsing fever is an illness characterized by recurring episodes of fever, headache, muscle pain, and other symptoms. The signs and symptoms of relapsing fever can vary from person to person, but common symptoms include:

• Fever: High temperature, usually lasting 2-9 days, with alternating periods of afebrile (no fever) intervals.
• Headache: Severe headache is a common symptom, often accompanied by muscle or joint pain.
• Muscle and joint pain: Pain in the muscles and joints, which can be severe.
• Nausea and vomiting: Some people may experience nausea and vomiting during episodes of fever.
• Rash: A rash may occur on the trunk and extremities in some cases.
• Chills: Sudden chills are a common symptom, often accompanied by high fever.
• Sweats: Sweating can be intense during episodes of fever.

It's worth noting that symptoms can vary from person to person, and not everyone will experience all of these symptoms. In general, relapsing fever is an illness characterized by recurring episodes of fever, headache, muscle pain, and other symptoms, with periods of apparent recovery in between.

References:

• [2] Most people who are infected develop sickness between 5 and 15 days after they are bitten.
• [3] Common symptoms include a sudden fever, chills, headaches, muscle or joint aches, and nausea. A rash may also occur.
• [4] Fever typically lasts 2 to 9 days and alternates with afebrile periods of 2 to 4 days.
• [11] Patients have sudden chills, high fever, severe headache, nausea, vomiting, muscle and joint pain, and often delirium and/or a rash on the trunk and extremities
• [12] Symptoms typically include high fever (e.g., 103⁰ F), along with shaking chills, headaches, muscle or joint aches, nausea, vomiting, and possibly rash.

Relapsing fever, also known as tick-borne relapsing fever (TBRF), can be challenging to diagnose due to its similarity to other diseases such as Lyme disease. However, several diagnostic tests are available to confirm the presence of this infection.

Blood Smears A blood smear is a simple and non-invasive test that involves examining a sample of blood under a microscope. In the case of relapsing fever, the spirochetes (bacteria) can be seen in the blood during a febrile episode [10][5]. The spirochetes may be visualized on darkfield or brightfield examination or Wright- or Giemsa-stained thick and thin blood smears.

Serologic Tests Serologic tests, such as enzyme-linked immunosorbent assay (ELISA), are available to detect the presence of antibodies against the bacteria that cause relapsing fever. However, these tests can be unreliable and may produce false-positive results [10][7].

Polymerase Chain Reaction (PCR) Testing Molecular testing for TBRF by PCR is also available from some commercial laboratories or through the Centers for Disease Control and Prevention (CDC). This test detects genetic material from the bacteria and is considered more accurate than serologic tests. The preferred specimen type for PCR testing is whole blood [3][4].

Other Diagnostic Tests Additional diagnostic tests, such as peripheral smear, direct or immunofluorescence staining, and dark-field microscopy, may also be performed to confirm the diagnosis of relapsing fever [14][8].

It's essential to note that a thorough medical, social, and travel history of the patient is crucial in diagnosing tick-borne relapsing fever. A combination of clinical presentation, laboratory tests, and epidemiological information can help confirm the diagnosis.

References: [1] Eldin C, Jaulhac B, Mediannikov O, Arzouni JP, Raoult D. Values of diagnostic tests for the various species of Borrelia. [2] Information on STRF diagnosis and testing, treatment, and disease reporting. [3] Diagnosis and testing. [4] Laboratory Studies · Peripheral blood smears · Polymerase Chain Reaction Testing · Direct or immunofluorescence staining, and dark-field microscopy. [5] TBRF can be diagnosed through a simple blood test during the time when you have the high fever. Most people with TBRF feel back to normal... [6] Serologic tests for relapsing fever and other borrelial infections are described in greater detail elsewhere. [7] A false-positive Lyme disease serology test result... [8] A number of diagnostic tests, including peripheral smear, was performed (Badger M. Tick talk: Unusually severe case of tick-borne relapsing fever: Case report and...). [9] TBRF can be diagnosed through a simple blood test during the time when you have the high fever. [10] The diagnosis of relapsing fever is suggested by recurrent fever and confirmed by visualization of spirochetes in the blood during a febrile episode. [11] The diagnosis of tick-borne relapsing fever requires an accurate characterization of the fever and a thorough medical, social, and travel history of the patient. [12] INTRODUCTION. Relapsing fever, caused by spirochetes of the Borrelia genus, is an arthropod-borne infection that occurs in two major forms: tick-borne (TBRF) and louse-borne (LBRF). [13] To diagnose relapsing fever, ... Sometimes polymerase chain reaction (PCR) tests are done that detect genetic material from the bacteria. [14] Serologic tests for relapsing fever and other borrelial infections are described in greater detail elsewhere.

Relapsing fever, also known as tick-borne relapsing fever (TBRF), is a systemic spirochetal disease characterized by recurrent episodes of fever, which accompany spirochetemia [7]. The differential diagnosis for relapsing fever includes several conditions that can present with similar symptoms.

Common Differential Diagnoses:

• Lyme arthritis
• Malaria
• Dengue
• Yellow fever
• Leptospirosis
• Typhus
• Influenza
• Enteric fevers [6]
• Colorado tick fever [8]

These conditions can present with similar symptoms, such as recurrent fever, chills, and malaise. However, the diagnosis of relapsing fever requires a careful history with attention to travel history and other geographic information, living conditions, and the temporal pattern of the symptoms [2].

Other Differential Diagnoses:

• Brucellosis
• Ehrlichiosis
• Tularemia
• Typhoid Fever
• Rat bite fever
• Rickettsial Infection

It's essential to note that the diagnosis of relapsing fever is suggested by recurrent fever and confirmed by visualization of spirochetes in the blood during a febrile episode [10]. The spirochetes may be seen on darkfield or brightfield examination or Wright- or Giemsa-stained thick and thin blood smears.

References:

[1] Schwan TG, Nilsson M, et al. Tickborne relapsing fever diagnosis obscured by malaria, Togo. Emerg Infect Dis. 2007 Jan. 13(1):117-23. [2] John and Gilsdorf review the evaluation and differential diagnoses for recurrent fever. [3] The diagnosis of tick-borne relapsing fever requires an accurate characterization of the fever and a thorough medical, social, and travel history of the patient. [4] Relapsing fever is an acute febrile illness caused by spirochetes of the genus Borrelia. [5] Differential diagnosis includes Lyme arthritis, malaria, dengue, yellow fever, and others. [6] The differential diagnosis of infectious diseases causing fevers that may relapse or have biphasic patterns includes Colorado tick fever, yellow fever, dengue, and others. [7] Relapsing fever, caused by spirochetes of the Borrelia genus, is an arthropod-borne infection that occurs in two major forms: tick-borne (TBRF) and louse-borne (LBRF). [8] Sustained fever is a pattern in which there is little change (0.3°C or less) in the elevated temperature during a 24-hour period. [9] INTRODUCTION. Relapsing fever, caused by spirochetes of the Borrelia genus, is an arthropod-borne infection that occurs in two major forms: tick-borne (TBRF) and louse-borne (LBRF). [10] The diagnosis of relapsing fever is suggested by recurrent fever and confirmed by visualization of spirochetes in the blood during a febrile episode.