AIMS OF THE LECTURE Identify the relapsing fever and the caused organism Clarify the routs of transmission Discuss the presentation and mention the differential diagnosis of this febrile illness. Identify the systemic complications of the disease Discuss the investigations needed to the diagnosis Explain the important lines of treatment Discuss the methods of prevention of the disease

Relapsing Fever

Defination acute recurrent febrile illnesse caused by bacteria in the genus Rickettsia and Borrelia . Tick-borne relapsing fever • Louse-borne relapsing fever a vector-borne disease transmitted by bites of lice or ticks

Onset is 5-15 days after bitten. Symptoms Onset is 5-15 days after bitten. Sudden fever. For 10 days, than relapse tachycardia. Headache 95% , cough and chills in 90%. Myalgias, Petechia bleeding Hepato - splenomegaly. CNS: coma, cranial neuropathy as Bell palsy, hemiplegia, meningitis, and fits

Poor prognostic signs include High bilirubin and jaundice, Unconsciousness Bleeding tendency, prolonged QT interval on ECG.

Diagnosis Blood smear stained with Giemsa or Wright stain.

THERAPY Tetracycline or Doxycycline is very effective, a Jarisch-Herxheimer reaction, fever,sweat tachycardia with hypotension.. Mortality rate is ** 1% with treatment ** 30-70% without treatment