[A patient with fever following a visit to the tropics: tick-borne relapsing fever discovered in a thick blood smear preparation].
A 26-year-old woman presented with a 2-day history of fever peaking to 39 degrees C and cold shivers that developed after a 2-weeks trip to Guatemala and Belize. Prior to the fever the patient had felt symptoms of a common cold and general malaise. Moreover, she complained of generalised myalgia and nausea. She had taken paludrine as a prophylactic against malaria. Borrelia spirochaetes, the pathogen of relapsing fever, were detected in a thick blood smear preparation. On the basis of the anamnesis, geography and specific exposure, the patient had a form of relapsing fever that is transmitted by ticks and not by lice: tick-borne relapsing fever. She was treated with doxycycline, 100 mg b.i.d. for 7 days. She could be discharged home in good condition after 2 days.
Heerdink
G
G
Havenziekenhuis en Instituut voor Tropische Ziekten, Haringvliet 2, 3011 TD Rotterdam.
Petit
P L C
PL
Hofwegen
H
H
van Genderen
P J J
PJ
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001531:Belize; D001898:Borrelia / Q000302:isolation & purification*; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D006166:Guatemala; D006801:Humans; D012061:Relapsing Fever / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D014195:Travel; D016896:Treatment Outcome; D014329:Tropical Climate
D000900:Anti-Bacterial Agents; D004318:Doxycycline