[Neurological complications of tick-borne relapsing fever].
BACKGROUND
Tick-borne relapsing fever (TBRF) can cause neurological complications. There are hardly any studies in Spain on this subject.


OBJECTIVE
To study the prevalence and clinical characteristics of neurological complications of patients with TBRF.


METHODS
We retrospectively reviewed all the patients attended with TBRF over 12 years (2004-2015) in a hospital in a rural area of southern Spain.


RESULTS
We included 75 patients, 42 males (56%). Mean age: 33 years (range: 14-72 years). Tick bites were observed in 9 patients (12%). The most common symptoms were: fever in 64 (85.3 %) patients, headache in 41 (54.6%) patients, and vomits in 26 (34.6%) patients. Manifestations suggesting meningeal involvement were noted in 9 (12%) of the patients, and 3 patients (4%) had clear meningeal signs on admission. All these patients underwent lumbar puncture. None of the patients presented facial palsy or other neurologic manifestation. Cerebrospinal fluid abnormalities were found in the three patients with meningismus. In one case Borrelia were found in the cerebrospinal fluid. In those cases with neurologic involvement the treatment used was penicillin G in one case and ceftriaxone in two patients. All patients recovered completely.


CONCLUSIONS
TBRF is one of the less severe forms of borreliosis and less than 5% of patients present neurological complications. However, physicians should know that Borrelia can cause meningitis in subjects exposed to ticks in endemic regions of TBRF.
Hospital Universitario Virgen Macarena, Sevilla, Espana.
L
L
Castilla-Guerra
Hospital Universitario Virgen de Valme, 41014 Sevilla, Espana.
M C
MC
Fernandez-Moreno
Hospital Universitario Virgen de Valme, 41014 Sevilla, Espana.
S
S
Vergara-Lopez
Hospital de la Merced, Osuna, Espana.
M
M
Merino-Rumin
Hospital Universitario Virgen Macarena, 41003 Sevilla, Espana.
M A
MA
Colmenero-Camacho
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002443:Ceftriaxone / Q000627:therapeutic use; D005260:Female; D006261:Headache; D006801:Humans; D008297:Male; D008578:Meninges / Q000503:physiopathology; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use; D012061:Relapsing Fever / Q000134:cerebrospinal fluid / Q000150:complications* / Q000188:drug therapy; D013030:Spain; D013987:Ticks; D014839:Vomiting; D055815:Young Adult
D002443:Ceftriaxone; D010400:Penicillin G