Relapsing fever borreliosis

Organism name Arthropod vector/reservoir Vertebrate reservoirs Clinical infection Geographic region
B. recurrentis Pediculus humanus humanus Man LBRF – human Africa (formerly worldwide)
B. baltazardii Unknown Unknown TBRF – human Iran
B. crocidurae Ornithodoros sonrai Rodents TBRF – human West Africa
B. duttonii Ornithodoros moubata Man TBRF – human Africa (Central, Eastern)
B. hermsii Ornithodoros hermsi Rodents TBRF – human; canine Canada, Western USA
B. hispanica Ornithodoros marocanus; Ornithodoros occidentalis; Ornithodoros kairouanensis
(formerly Ornithodoros erraticusa)
Rodents TBRF – human Algeria, Morocco, Portugal, Spain, Tunisia
B. latyschewii Ornithodoros tartakovskyi Rodents; reptiles TBRF – human Central Asia, Iran, Iraq
B. mazzottii Ornithodoros talaje Armadillos; rodents TBRF – human Southern USA, Mexico, Guatemala
B. merionesi Ornithodoros costalis
Ornithodoros merionesi
Rodents Unknown North Africa
B. microti Ornithodoros erraticusb Africa, Iran
B. parkeri Ornithodoros parkeri Rodents TBRF – human Western USA
B. persica Ornithodoros tholozani Rodents; bats TBRF – human; cat Asia, Middle East
B. turicatae Ornithodoros turicata Rodents TBRF – human; canine; birds USA, Mexico
B. venezuelensis Ornithodoros rudis Rodents TBRF – human Central and South America

a Ornithodoros erraticus represented a complex. Recent taxonomic molecular studies redressed the phylogeny suggesting that O. erraticus sensu stricto is not an efficient vector for Borrelia.

b Molecular confirmation of O. erraticus identity unavailable at time of writing.

Abbreviations: LBRF = louse-borne relapsing fever; TBRF = tick-borne relapsing fever.

Clinical presentation

The chief sign is that of fever, often accompanied by chills, headaches, arthralgia, myalgia, and tachycardia. Other signs may include jaundice, petecheal rash, conjunctivitis, nausea, hepatosplenomegaly, and epistaxis. Infection with Borrelia duttonii has been associated with significant perinatal mortality in endemic regions such as Tanzania.

Although eventually eliminated by the adaptive immune response, repeat infections can occur in a previously infected individual.

Treatment (Table 165.2)

Cases are usually managed with penicillin, doxycycline, or tetracycline treatment. Some prefer penicillin as it is believed that this makes Jarisch–Herxheimer reactions (JHR) less likely. Less frequently, cephalosporins, erythromycin, and chloramphenicol have been used.

Table 165.2 Treatment of relapsing fever borreliosis

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Jun 18, 2016 | Posted by in INFECTIOUS DISEASE | Comments Off on Relapsing fever borreliosis

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Antibiotic Dosage used Duration Comments
Penicillin 400 000–600 000 IU daily 7 to 14 d Single dose can be curative for LBRF
CNS involvement
Tetracycline 200–250 mg BID to 500 mg QID 7 to 14 d Single dose can be curative for LBRF
Doxycycline 200-250 mg
4 mg/kg/d
7 to 14 d Can be used as prophylaxis (200 mg d 1, then 100 mg daily 4 d post exposure)