LOUSE-BORNE RELAPSING FEVER

Overview and Facts

Louse-borne relapsing fever (LBRF) is a vector-borne infection characterized by the spirochaete Borrelia recurrentis, a restricted human infection spread by the body louse Pediculus humanus humanus. A person dies in 10% to 40% of cases when adequate therapy is unavailable and in 2% to 5% of treated patients. In addition, antibiotic treatment may cause a possibly lethal Jarisch-Herxheimer response.

Furthermore, severe epidemics of louse-borne relapsing fever have formerly arisen in Africa and Eurasia, although the illness is now predominantly prevalent in northern Africa. The primary treatment of louse-borne relapsing fever is based on preventing body lice infection. Infections of this kind are associated with inadequate personal cleanliness, overpopulation, and low socioeconomic level.

Types and Symptoms

SYMPTOMS

Louse-borne relapsing fever usually takes four to eight days to develop. The signs are linked to the movement of microorganisms in the blood.

Symptoms often appear suddenly and include:

  • Vomiting
  • Nausea
  • Arthralgia or myalgia
  • Meningism
  • Headache
  • Sweats and chills
  • General malaise
  • High fever

Severe symptoms include:

  • Hyperpyrexia
  • Acute pulmonary edema
  • Acute respiratory syndrome
  • Cerebral or Gastrointestinal bleeding
  • Damaged spleen
  • Liver problem
  • Jarisch–Herxheimer reactions (J-HR)
  • opportunistic typhoid

Diagnosis & Medications

DIAGNOSIS

The microscope of blood films is utilized for diagnostic testing, although polymerase chain reaction is progressively employed for species identification. In addition, acute leptospirosis and falciparum malaria are essential differential diagnoses for inhabitants and visitors from suitable geographical locations.

  • The direct detection of spirochaetes in the blood is the preferred diagnostic technique.
  • Borrelia are spirochaetes that may be recognized on stained blood films (Giemsa), particularly in the febrile phase.

TREATMENT

Controlling outbreaks entails sterilizing clothes to eradicate lice, employing pediculicides, and increasing personal cleanliness. The following antibiotics are used to treat suspects and close contacts:

Doxycycline PO

  • Adults: 200 mg single dose
  • Children: 4 mg/kg (maximum of 100 mg) in a single dosage

Erythromycin PO

  • For adults and children aged five and up 500 mg single dose
  • Children under five years: 250 mg single dose

Azithromycin PO

  • Adults: 500 mg single dose
  • 10 mg/kg (maximum 500 mg) single dosage for children

Furthermore, although a single dose of antibiotic is successful in most cases of louse-borne relapsing fever, a long treatment term is typically used to reduce the likelihood of relapse. The following antibiotics are recommended for confirmed cases:

  • Chloramphenicol
  • Erythromycin
  • Penicillin G
  • Tetracycline

Related Articles

MENINGIOANGIOMATOSIS

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Meningioangiomatosis is a rare benign condition characterized by the presence of [...]

MYELOFIBROSIS

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Myelofibrosis is a rare and chronic bone marrow disorder characterized by [...]

MAFFUCCI SYNDROME

Overview and FactsTypes and SymptomsDiagnosis & MedicationsOverview and Facts Maffucci syndrome is a rare genetic disorder characterized by the development [...]