Borreliosis Flashcards
What is louse borne relapsing fever?
Borrelia recurrentis, spirochetes
How is borrelia transmitted?
contamination of broken skin/intact mucosae by coelomic fluid of lice inoculated by scratching
Where is borrelia recurrentis found?
Currently confined to Horn of Africa and South Sudan
Name some other louse borne diseases?
Rickettsia Prowazekii (epidemic typhus)
Bartonella Quintana
Yersinia Pestis
Where do the lice live?
on clothes, particularly lining. When not on the body, eggs and adults die
Spirochetes cause what classic clinical feature?
Relapse phenomenon
Symptoms of louse borne relapsing fever?
Sudden high fever, chills, headache, confusion
Jaundice, bleeding, HSM
Relapsing fever means?
Periods of fever, ends with crisis fever, and then period of remission before fever starts again.
Complications of louse borne relapsing fever
*Myocarditis, acute LVF and
pulmonary oedema
* Hepatic failure
* Severe bleeding
(thrombocytopenia, DIC)
* Splenic infarction and rupture
* Secondary bacterial infection:
(Salmonella, typhoid,
Shigella, malaria, typhus,
tuberculosis)
Biopsy what do you see?
Splenic miliary microabscesses
Spirochetes
What is Jarisch-Herxheimer reaction?
Fatal reaction to treatment
Chill phase: Disappearance of spirochetes causing leucopenia -> intense rigors, chills, hypotension
Flush phase: slowly declining
temperature, vasodilatation, high cardiac output
How to avoid the JH reaction?
Small dose penicillin prior to Rx with tetracycline
Good supportive care
Best antibiotic for LBRF?
Tetracycline single dose
Benpen - less chance of JH reaction
Tick borne relapsing fever how transmitted?
by tick’s saliva (during blood meal),
tick’s coxal gland secretion (via bite wound)
Difference between tick borne relapsing fever and louse borne relapsing fever?
Louse borne - only affects human, only in Horn of Africa
Tick borne - zoonosis, affects mammals, more global
What is the diagnosis?
Relapsing fever - could be either
