title: Relapsing Fever: Diagnosis Thanks to a Vigilant Hematology Laboratory.
abstract: Three cases of relapsing fever from southern Israel were diagnosed promptly thanks to vigilance of the hematology laboratory technicians. In this region of Israel, patients presenting with prolonged fever and leukopenia without localizing symptoms are generally suspected of having brucellosis or a rickettsial disease. Pediatric patients with prolonged fever, cytopenias, and negative aforementioned serologies are often hospitalized for further work-up. Because of the policy of performing a manual blood smear when results of the automated blood count demonstrate severe anemia and abnormal platelet and/or white blood cell counts, a diagnosis of tick-borne relapsing fever was confirmed and promptly relayed to the physician. This routine prevented unnecessary examinations and hospitalization days and provided important information to regional epidemiology and public health authorities.
authors.affiliation: 1 Clalit Health Services , Southern district, Beer Sheva, Israel .|2 Medical School for International Health, Ben Gurion University of the Negev , Beer Sheva, Israel .
authors.forename: Inbal
authors.initials: I
authors.lastname: Fuchs
authors.affiliation: 1 Clalit Health Services , Southern district, Beer Sheva, Israel .
authors.forename: Salman
authors.initials: S
authors.lastname: Tarabin
authors.affiliation: 3 Soroka University Medical Center , Beer Sheva, Israel .
authors.forename: Michael
authors.initials: M
authors.lastname: Kafka
mesh_terms: D000328:Adult; D000818:Animals; D001898:Borrelia / Q000302:isolation & purification*; D002648:Child; D005260:Female; D006405:Hematology / Q000379:methods / Q000592:standards*; D006801:Humans; D007557:Israel; D007753:Laboratories / Q000592:standards*; D008297:Male; D012061:Relapsing Fever / Q000175:diagnosis* / Q000382:microbiology
keywords: Diagnosis; Peripheral smear; Tick-borne relapsing fever