Relapsing fever history and symptoms
|
Relapsing fever Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Relapsing fever history and symptoms On the Web |
|
American Roentgen Ray Society Images of Relapsing fever history and symptoms |
|
Risk calculators and risk factors for Relapsing fever history and symptoms |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The symptoms of relapsing fever present 3-7 days (up to 18 days) after exposure with sudden onset of high fever, chills, headache, myalgias, and weakness. Less common symptoms include anorexia, nausea, vomiting, abdominal pain, arthralgias, neck pain or back pain, confusion, lethargy, cough, rash, sore throat, and swollen lymph nodes.If left untreated, rapid defervescence usually occurs in 2-6 days (range 1-13 days), often with dramatic improvement in symptoms. Most cases eventually resolve spontaneously.The clinical manifestations of tick-borne and louse-borne relapsing fever are similar but can be quite variable, depending on the infecting strain of Borrelia and the host's immunity.
History and Symptoms
The clinical manifestations of tick-borne and louse-borne relapsing fever are similar but can be quite variable, depending on the infecting strain of Borrelia and the host's immunity. Patients typically present 3-7 days (up to 18 days) after exposure with sudden onset of high fever, chills, headache, myalgias, and weakness.
Incubation period = time from tick bite to illness
- 7 days, range 2 to 18 days
Symptomatic period= Length of illness = time from symptom onset to resolution of symptoms
- 3 days, range 2 to 7 days
- In LBRF, the fever usually lasts 3-6 days and is usually followed by a single, milder episode. In TRBF, multiple episodes of fever occur, and each may last up to 3 days.
Number of relapses = number of episodes of reoccurring/relapsing symptoms
- 3 times, can occur up to 10 times in persons who are not treated. Most cases eventually resolve spontaneously.
- Patients with louse-borne relapsing fever will typically have 1-2 relapses (range 0-6) with each subsequent relapse usually less severe than the previous one.
- Patients with tick-borne relapsing fever usually have 3-5 relapses (range 0-22).
Afebrile period= Length of time before reoccurrence = time from the resolution of symptoms to reoccurrence of symptoms
- 7 days, range 4 to 14 days
Crisis
- AS mentioned before, most cases eventually resolve spontaneously. Occasionally, the crisis occurs after the resolution, which is a classic series of stages that a person will go through:
- 1. Phase one is the chill phase, with the person experiencing high fevers up to 41.5°C (106.7°F). With this high temperature, a person can develop delirium, agitation, and confusion. In addition, other signs of an increased metabolic rate are noted, such as a fast heart rate and breathing rate. This phase lasts between 10 and 30 minutes.
- 2. Phase two is the flush phase. This is where the body temperature decreases rapidly, and the person has drenching sweats. During this phase, the person's blood pressure can drop dramatically[1]
- During the crisis, patients may develop cerebral edema with seizures, cardiac failure, or death. This stage may result in death in up to 10% of patients.
Common symptoms
- The symptoms of Relapsing fever usually develop within 3-7 days after exposure and start with sudden onset of:
- High fever
- chills
- headache
- myalgias
- weakness
Less common symptoms
- Anorexia
- Nausea
- Vomiting
- Abdominal pain
- Arthralgias
- Neck or back pain
- Confusion
- Lethargy
- Cough
- Rash
- Sore throat
- Swollen lymph nodes