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__NOTOC__
'''For patient information click [[Relapsing fever(patient information)|here]]'''
'''For patient information click [[Relapsing fever(patient information)|here]]'''
{{Infobox_Disease |
  Name          = Relapsing fever |
  Image          = |
  Caption        = |
  DiseasesDB    = 1547 |
  ICD10          = {{ICD10|A|68||a|65}} |
  ICD9          = {{ICD9|087}} |
  ICDO          = |
  OMIM          = |
  OMIM_mult      = |
  MedlinePlus    = |
  eMedicineSubj  = emerg |
  eMedicineTopic = 590 |
  eMedicine_mult = {{eMedicine2|med|1999}} |
  MeshID        = D012061 |
}}
{{Relapsing fever}}
{{Relapsing fever}}
{{About1|Borrelia}}
{{CMG}}
{{CMG}}
{{SK}} Tick-borne relapsing fever, louse-borne relapsing fever；Recurrent fever； Recurrent fever due to Borrelia； Relapsing fever due to Borrelia


==[[Relapsing fever overview|Overview]]==
==[[Relapsing fever overview|Overview]]==


==[[Relapsing fever historical perspective|Historical Perspective]]==
==[[Relapsing fever historical perspective|Historical Perspective]]==
==[[Relapsing fever classification|Classification]]==


==[[Relapsing fever pathophysiology|Pathophysiology]]==
==[[Relapsing fever pathophysiology|Pathophysiology]]==


==[[Relapsing fever epidemiology and demographics|Epidemiology & Demographics]]==
==[[Relapsing fever causes|Causes]]==
 
==[[Relapsing fever risk factors|Risk Factors]]==


==[[Relapsing fever screening|Screening]]==
==[[Relapsing fever differential diagnosis|Differentiating Relapsing fever from other Diseases]]==


==[[Relapsing fever causes|Causes]]==
==[[Relapsing fever epidemiology and demographics|Epidemiology and Demographics]]==


==[[Relapsing fever differential diagnosis|Differentiating Relapsing fever]]==
==[[Relapsing fever risk factors|Risk Factors]]==


==[[Relapsing fever natural history|Complications & Prognosis]]==
==[[Relapsing fever natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
[[Relapsing fever history and symptoms|History and Symptoms]] | [[Relapsing fever physical examination|Physical Examination]] | [[Relapsing fever laboratory tests|Laboratory tests]] | [[Relapsing fever electrocardiogram|Electrocardiogram]]  | [[Relapsing fever x ray|X Rays]] | [[Relapsing fever CT|CT]] | [[Relapsing fever MRI|MRI]] [[Relapsing fever echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Relapsing fever other imaging findings|Other images]] | [[Relapsing fever other diagnostic studies|Alternative diagnostics]]
[[Relapsing fever history and symptoms|History and Symptoms]] | [[Relapsing fever physical examination|Physical Examination]] | [[Relapsing fever laboratory findings|Laboratory Findings]] | [[Relapsing fever other imaging findings|Imaging Findings]] | [[Relapsing fever other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
[[Relapsing fever medical therapy|Medical therapy]] | [[Relapsing fever surgery|Surgical options]] | [[Relapsing fever primary prevention|Primary prevention]]  | [[Relapsing fever secondary prevention|Secondary prevention]] | [[Relapsing fever cost-effectiveness of therapy|Financial costs]] | [[Relapsing fever future or investigational therapies|Future therapies]]
[[Relapsing fever medical therapy|Medical Therapy]] | [[Relapsing fever primary prevention|Prevention]] | [[Relapsing fever cost-effectiveness of therapy|Cost-effectiveness of Therapy]] | [[Relapsing fever future or investigational therapies|Future or Investigational Therapies]]
 
== Treatment ==
=== Pharmacotherapy ===
Erythromycin, tetracyclines, chloramphenicol, or penicillins have all been shown to be effective for treating TBRF.  Although duration of therapy has not been well studied for TBRF, the current recommendation is seven days of antibiotic therapy.  In contrast, LBRF caused by B. recurrentis can be treated with a single dose of antibiotics.
 
For young children and pregnant women either erythromycin and/or penicillin are recommended for treatment of TBRF.
 
When initiating antibiotic therapy, a patient should be watched closely for a [[Jarisch-Herxheimer]] reaction for the first 4 hours after the antibiotic is given (Negussie, Remick et al. 1992).  The reaction may be difficult to distinguish from a febrile crisis, with rigors and decreased blood pressure.  Cooling blankets and appropriate use of antipyrectic agents may be indicated.
The Jarisch-Herxheimer reaction produces apprehension, [[diaphoresis]], fever, [[tachycardia]], and [[tachypnea]] with an initial pressor response followed rapidly by [[hypotension]]. Recent studies have shown that [[tumor necrosis factor-alpha]] (TNF-alpha) may be partly responsible for the reaction.
 
==== Acute Pharmacotherapies ====
The CDC has not developed specific treatment guidelines for TBRF.  Below are the treatment recommendations as outlined in Harrisons Principles of Internal Medicine. 16th edition. 2004. p 994.


[[Image:Treatment.jpg|left|Treatment]]
==Case Studies==
{{clr}}
<ref>http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_Treatment.htm
</ref>


==Prevention==
[[Relapsing fever case study one|Case #1]]
In order to prevent relapsing fever, one should:
*Avoid sleeping in rodent infested buildings.
*Limit tick bites by using insect repellent containing DEET (on skin or clothing) or permethrin (applied to clothing or equipment).
*Rodent-proof buildings in areas where the disease is known to occur.
*Identify and remove any rodent nesting material from walls, ceilings and floors.
*In combination with removing the rodent material, fumigate the building with preparations containing pyrethrins and permethrins. More than one treatment is often needed to effectively rid the building of the vectors, the soft-ticks. Always folllow product product instructions, and consider consulting a liscensed pest control specialist.<ref>http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_Prevention.htm
</ref>


==See also==
==Related Chapters==
*[[Lyme disease]]
*[[Lyme disease]]
*[[Typhus]]
*[[Typhus]]


== Acknowledgements ==
==External Links==
The content on this page was first contributed by: [[C. Michael Gibson]] M.S., M.D.
 
List of contributors:
 
Pilar Almonacid
 
==References==
{{Reflist|2}}
 
==External links==
* {{eMedicineDictionary|Relapsing+fever}}
* [http://www.cdc.gov/ncidod/dvbid/RelapsingFever/index.htm CDC: Relapsing Fever]
* [http://www.cdc.gov/ncidod/dvbid/RelapsingFever/index.htm CDC: Relapsing Fever]
{{Spirochetal diseases}}
{{Spirochetal diseases}}
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[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Zoonoses]]
[[Category:Zoonoses]]
[[Category:Infectious disease]]
[[Category:Infectious diseases]]
[[Category:Overview complete]]
 
[[pl:Dur powrotny]]
[[pl:Dur powrotny]]


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Revision as of 20:16, 7 August 2015

For patient information click here

Relapsing fever Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Relapsing fever from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see Borrelia.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Tick-borne relapsing fever, louse-borne relapsing fever；Recurrent fever； Recurrent fever due to Borrelia； Relapsing fever due to Borrelia

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Relapsing fever from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Prevention | Cost-effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

External Links

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