Relapsing fever history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
- Sudden onset of high fever, chills, headache, myalgias, and weakness, occur within 3-7 days (up to 18 days) after exposure. Less common symptoms include anorexia, nausea, vomiting, abdominal pain, arthralgias, neck 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.This cycle may continue for several weeks if the person is not treated.Most cases eventually resolve spontaneously. Occasionally, resolution ensues by Crisis. 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 people.Occasionally, crisis occurs after resolution,which is a classic series of stages that a person will go through and may result in death in up to 10% of patients.
History and Symptoms
- The clinical manifestations of tick-born and louse-born relapsing fever are similar but can be quite variable, depending on the infecting strain of Borrelia and the host's immunity.
- The symptoms of Relapsing fever usually develop within 3-7 days after exposure and start with sudden onset of high fever, chills, headache, myalgias, and weakness, followed by afebrile periods.
- The afebrile interval usually lasts 1 week (up to 60 days) before relapse with symptoms similar to the first episode. 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).
- This cycle may continue for several weeks if the person is not treated. Most cases eventually resolve spontaneously. Occasionally, resolution ensues by Crisis. 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 people.
Timing
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.
Afebrile period= Length of time before reoccurrence = time from resolution of symptoms to reoccurrence of symptoms
- 7 days, range 4 to 14 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.[1]
Crisis
- Occasionally, resolution ensues by crisis 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[2]
- 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 people.
References
- ↑ http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_biology.htm http://www.cdc.gov/ncidod/dvbid/RelapsingFever/index.htm 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). http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_Symptoms.htm
- ↑ http://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_biology.htm http://www.cdc.gov/ncidod/dvbid/RelapsingFever/index.htmhttp://www.cdc.gov/ncidod/dvbid/RelapsingFever/RF_Symptoms.htm