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relapsing fever
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tick-borne relapsing fever, louse-borne relapsing fever, relapsing fever, infection transmitted by a louse, tick, characterized by repeated episodes of fever, relapsing fever, infection, bacteria, in the borrelia family, two major forms, tick-borne relapsing fever, tbrf, transmitted by the ornithodoros tick, occurs in africa, spain, saudi arabia, asia, certain areas, in the western us, canada, louse-borne relapsing fever, lbrf, is transmitted by body lice, prevalent, in the developing world, asia, africa, central, south america, 2 weeks of infection, people develop sudden-onset high fever, in louse-borne relapsing fever, initial episode, lasts 3-6 days, followed by a single, milder episode, in tick-borne relapsing fever, multiple episodes of fever occur, each, last up to 3 days, individuals free of fever, up to 2 weeks, prior to a relapse, in both forms, fever episode, end in "crisis", which consists of shaking chills, followed by intense sweating, falling temperature, low blood pressure, stage, death, 10% of individuals, after several cycles of fever, develop dramatic central nervous system signs seizures, stupor, coma, borrelia organism, invade heart, liver tissues, causing inflammation, the heart muscle, myocarditis, inflammation, the liver, hepatitis, diffuse bleeding, pneumonia, complications of this illness, tbrf, occurs west, the mississippi river, in the mountainous west, high deserts, plains, the southwest, mountains of california, utah, arizona, new mexico, colorado, oregon, washington, infections, b, hermsii, acquired in cabins in forests, that the risk now extends, southeastern united states, lbrf is mainly a disease, the developing world, occurs in epidemics, currently prevalent in ethiopia, sudan, famine, war, movements, congregations of refugees often result in epidemics of lbrf, largest epidemics of lbrf, century occurred, two world wars, millions of people were infected in these epidemics, at least 1 million deaths, sudden onset of high fever, rigors, headache, neck stiffness, nausea, vomiting, muscle aches, myalgia, joint aches, arthralgia, bleeding, seizures, unsteady gait, facial droop, coma, weakness, relapsing fever, suspected in someone coming, endemic area who has repeated episodes of fever, fever is followed by a "crisis" stage, person thinks they, have been exposed to lice, soft-bodied ticks, a blood smear is frequently obtained, organism is present, a culture, organism is not widely available in most laboratories, certain blood antibody tests, used, mainstay of treatment is antibiotics, primarily tetracycline, doxycycline, penicillin, mortality, death, untreated louse-borne relapsing fever ranges from 10-70%, from 4-10% in tick-borne relapsing fever, early treatment, mortality rate is reduced to 2-5%, individuals, coma, myocarditis, liver dysfunction, pneumonia, at higher risk of death, neurologic complications, seizures, weakness, facial droop, meningitis, coma, myocarditis, lead to arrhythmias, pneumonia, liver dysfunction, diffuse bleeding, jarisch, herxheimer's reaction, antibiotic therapy fatal notify medical provider, a returning traveler, develop fever, many different possible infections, investigated, timely manner, wearing proper clothing, insect repellent, prevent infection, lice, tick control in endemic areas is another important public health measure.
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