Tickborne relapsing fever

Bacterial infection caused by Borrelia spirochetes transmitted through bite of Ornithodoros ticks.

Acute febrile illness associated with remissions and relapses and is transmitted by several types of soft ticks.

Infection from a blood meal of an infected tick.

Bites of soft ticks usually go unnoticed unlike those from hard ticks.

Rate of transmission from a tick bite is 50%.

Incubation period 2-18 days.

Borrelia spirochetes are the cause of the illness.

Patients typically present with high fever, dizziness, headaches, with myalgias and arthralgias.

Rare complications include myocarditis, arrhythmias, intracerebral bleeding and liver dysfunction.

Diagnosis based on identifying Borrelia spirochetes on blood smear.

Manifests as relapsing fever, myalgias, and malaise.

Primarily in Africa, Spain, Saudi Arabia, Asia in and certain areas of Canada and the western United States

Endemic in Western US.

Often acquired in individuals lodging in rodent infested dwellings at an elevation greater than 2000 ft.

B. hermsii most frequent cause in the US, and transmited by soft tick Ornithodoros hermsi.

Ornithodoros associated with chipmunk nests and other rodents.

Spirochetes transmitted by a painless nocturnal tick bite of less than 30 minute duration.

Incubation period of 7 days.

Symptoms of headache, fever, myalgias, nausea, chills with median duration of 3 days, but the illness can last up to 14 days.

May be associated with thrombocytopenia.

Blood smears can reveal circulating spirochetes during acute infection.

Antibiotic treatments include penicillin, doxycycline, and erythromycin.

Treatment may be associated with a Jarisch-Herxheimer reaction, an acute worsening of symptoms.

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