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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 3. Summaries of Infectious Diseases
Borrelia Infections
(Relapsing Fever)Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Relapsing fever is characterized by the sudden onset of high fever, shaking chills, sweats, headache, muscle and joint pains, and progressive weakness. A fleeting macular rash of the trunk and petechiae of the skin and mucous membranes sometimes occur. Complications include hepatosplenomegaly, jaundice, epistaxis, iridocyclitis, cough with pleuritic pain, pneumonitis, meningitis, and myocarditis. Untreated, an initial febrile period of 3 to 7 days terminates spontaneously by crisis. The initial febrile episode is followed by an afebrile period of several days to weeks, then by one or more relapses. Relapses typically become progressively shorter and milder as the afebrile periods lengthen. Infection during pregnancy often is severe and can result in abortion, stillbirth, or neonatal infection.
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ETIOLOGY: Relapsing fever is caused by certain spirochetes of the genus Borrelia. Borrelia recurrentis is the only species that causes louseborne (epidemic) relapsing fever, and there is no animal reservoir of B recurrentis. Worldwide, at least 15 Borrelia species cause tickborne (endemic) relapsing fever, including Borreliahermsii and Borrelia
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