Relapsing fever: Difference between revisions
Line 42: | Line 42: | ||
==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 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]] | ||
== Treatment == | == Treatment == |
Revision as of 17:08, 7 February 2012
For patient information click here
Relapsing fever | |
ICD-10 | A68 |
---|---|
ICD-9 | 087 |
DiseasesDB | 1547 |
eMedicine | emerg/590 med/1999 |
MeSH | D012061 |
Relapsing fever Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Relapsing fever On the Web |
American Roentgen Ray Society Images of Relapsing fever |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
Pathophysiology
Epidemiology & Demographics
Risk Factors
Screening
Causes
Differentiating Relapsing fever
Complications & Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics
Treatment
Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future 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.
Prevention
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.[2]
See also
Acknowledgements
The content on this page was first contributed by: C. Michael Gibson M.S., M.D.
List of contributors:
Pilar Almonacid