Borrelia recurrentis - Revision history

Aidan: /* Microbiology */

2022-07-06T02:04:33Z

Microbiology

← Older revision		Revision as of 02:04, 6 July 2022
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	==Background==		==Background==
	=== Microbiology ===		=== Microbiology ===
	* [[Shape::Spirochete]]		* [[Shape::spirochete\|Spirochete]]
	* Serotypes are determined by the outer membrane variable major proteins (vmp)		* Serotypes are determined by the outer membrane variable major proteins (vmp)
	* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)		* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)

Aidan: Text replacement - "[[Cellular shape::" to "[[Shape::"

2020-10-10T22:31:44Z

Text replacement - "[[Cellular shape::" to "[[Shape::"

← Older revision		Revision as of 22:31, 10 October 2020
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	==Background==		==Background==
	=== Microbiology ===		=== Microbiology ===
	* [[~~Cellular shape~~::Spirochete]]		* [[Shape::Spirochete]]
	* Serotypes are determined by the outer membrane variable major proteins (vmp)		* Serotypes are determined by the outer membrane variable major proteins (vmp)
	* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)		* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)

Aidan: /* Clinical Manifestations */

2020-08-05T13:53:25Z

Clinical Manifestations

← Older revision		Revision as of 13:53, 5 August 2020
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	== Clinical Manifestations ==		== Clinical Manifestations ==
	* Incubation period of 7 days (range 2 to 18 days)		* Incubation period of [[Usual incubation period::7 days]] (range [[Incubation period range::2 to 18 days]])
	* Relapsing fevers: febrile for 3 days, afebrile for 7 days		* Relapsing fevers: febrile for 3 days, afebrile for 7 days
	* Some patients will have lymphadenopathy, hepatosplenomegaly, and a rash		* Some patients will have lymphadenopathy, hepatosplenomegaly, and a rash

Aidan: Text replacement - "Has vector::" to "Vector::"

2020-08-02T13:54:46Z

Text replacement - "Has vector::" to "Vector::"

← Older revision		Revision as of 13:54, 2 August 2020
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	=== Epidemiology ===		=== Epidemiology ===
	* Vector-borne disease transmitted by the human body louse (''[[~~Has vector~~::Pediculus humanus humanus]]'')		* Vector-borne disease transmitted by the human body louse (''[[Vector::Pediculus humanus humanus]]'')
	* LBRF was present nearly worldwide prior to World War II, but is now present in Ethiopia		* LBRF was present nearly worldwide prior to World War II, but is now present in Ethiopia
	* Associated with homelessness and refugee camps		* Associated with homelessness and refugee camps

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-14T23:54:06Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 23:54, 14 July 2020
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	** This is the cause of the relapsing fever		** This is the cause of the relapsing fever

	== Clinical ~~Presentation~~ ==		== Clinical Manifestations ==
	* Incubation period of 7 days (range 2 to 18 days)		* Incubation period of 7 days (range 2 to 18 days)
	* Relapsing fevers: febrile for 3 days, afebrile for 7 days		* Relapsing fevers: febrile for 3 days, afebrile for 7 days

Aidan: Text replacement - "[[Has shape::" to "[[Cellular shape::"

2020-07-05T22:24:24Z

Text replacement - "[[Has shape::" to "[[Cellular shape::"

← Older revision		Revision as of 22:24, 5 July 2020
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	==Background==		==Background==
	=== Microbiology ===		=== Microbiology ===
	* [[~~Has~~ shape::Spirochete]]		* [[Cellular shape::Spirochete]]
	* Serotypes are determined by the outer membrane variable major proteins (vmp)		* Serotypes are determined by the outer membrane variable major proteins (vmp)
	* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)		* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)

Aidan at 15:14, 20 June 2020

2020-06-20T15:14:24Z

← Older revision		Revision as of 15:14, 20 June 2020
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	* Causes '''Louse-borne relapsing fever''' (LBRF)		* Causes '''Louse-borne relapsing fever''' (LBRF)

	== ~~Microbiology~~ ==		==Background==
			=== Microbiology ===
	* [[Has shape::Spirochete]]		* [[Has shape::Spirochete]]
	* Serotypes are determined by the outer membrane variable major proteins (vmp)		* Serotypes are determined by the outer membrane variable major proteins (vmp)
	* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)		* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)

	== Epidemiology ==		=== Epidemiology ===
			* Vector-borne disease transmitted by the human body louse (''[[Has vector::Pediculus humanus humanus]]'')

	* LBRF was present nearly worldwide prior to World War II, but is now present in Ethiopia		* LBRF was present nearly worldwide prior to World War II, but is now present in Ethiopia
	* Associated with homelessness and refugee camps		* Associated with homelessness and refugee camps

	== Pathophysiology ==		=== Pathophysiology ===

	* During febrile periods, spirochetes divide rapidly and cause a spirochetemia		* During febrile periods, spirochetes divide rapidly and cause a spirochetemia
	* This is followed by an immune response to the vmp proteins, which clears the spirochetemia and the patient becomes afebrile		* This is followed by an immune response to the vmp proteins, which clears the spirochetemia and the patient becomes afebrile
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	== Clinical Presentation ==		== Clinical Presentation ==

	* Incubation period of 7 days (range 2 to 18 days)		* Incubation period of 7 days (range 2 to 18 days)
	* Relapsing fevers: febrile for 3 days, afebrile for 7 days		* Relapsing fevers: febrile for 3 days, afebrile for 7 days
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	== Differential Diagnosis ==		== Differential Diagnosis ==

	* [[Typhus]]		* [[Typhus]]
	* '''[[Malaria]]'''		* '''[[Malaria]]'''
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	== Diagnosis ==		== Diagnosis ==

	* Often seen on blood film		* Often seen on blood film
	** Giemsa or Wright stains		** Giemsa or Wright stains

Aidan: /* Microbiology */ link

2019-12-29T00:12:30Z

Microbiology: link

← Older revision		Revision as of 00:12, 29 December 2019
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	== Microbiology ==		== Microbiology ==
		⚫	* [[Has shape::Spirochete]]

⚫	* Spirochete
	* Serotypes are determined by the outer membrane variable major proteins (vmp)		* Serotypes are determined by the outer membrane variable major proteins (vmp)
	* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)		* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)

Aidan at 10:36, 16 August 2019

2019-08-16T10:36:40Z

← Older revision		Revision as of 10:36, 16 August 2019
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	** Causes '''Louse-borne relapsing fever''' (LBRF)		* Causes '''Louse-borne relapsing fever''' (LBRF)

	== Microbiology ==		== Microbiology ==

Aidan: Initial creation separating from TBRF

2019-08-16T10:36:32Z

Initial creation separating from TBRF

New page

** Causes '''Louse-borne relapsing fever''' (LBRF)

== Microbiology ==

* Spirochete
* Serotypes are determined by the outer membrane variable major proteins (vmp)
* Grow in modified Kelly medium and stained by Wright stain (in peripheral blood film)

== Epidemiology ==

* LBRF was present nearly worldwide prior to World War II, but is now present in Ethiopia
* Associated with homelessness and refugee camps

== Pathophysiology ==

* During febrile periods, spirochetes divide rapidly and cause a spirochetemia
* This is followed by an immune response to the vmp proteins, which clears the spirochetemia and the patient becomes afebrile
* The vmp proteins undergo rearrangement, evading the immune system and allowing another spirochetemia
** This is the cause of the relapsing fever

== Clinical Presentation ==

* Incubation period of 7 days (range 2 to 18 days)
* Relapsing fevers: febrile for 3 days, afebrile for 7 days
* Some patients will have lymphadenopathy, hepatosplenomegaly, and a rash
* Rare complications include lymphocytic meningitis, Bell palsy and other cranial nerve palsies, paralysis, seizure, uveitis, endophthalmitis, ARDS, and myocarditis
* Can cause spontaneous abortion in pregnant women
* May be septic, with multiple organ involvement
* May have a Jarisch-Herxheimer reaction following empiric antibiotics

== Differential Diagnosis ==

* [[Typhus]]
* '''[[Malaria]]'''
* [[Typhoid fever]]
* [[Leptospirosis]]
* [[Viral hepatitis]]
* [[Dengue]]

== Diagnosis ==

* Often seen on blood film
** Giemsa or Wright stains
** 70% sensitive during febrile period for TBRF, lower for LBRF
* Acute-convalescent serology with IFA/EIA
** May cross-react with Lyme disease
* Can cause a false-positive VDRL
* Can be cultured with modified Kelly medium

== Management ==

* First-line: Doxycycline 200 mg po once
* Alternatives:
** Penicillin G 400-800 kU IM once
** Erythromycin 500 mg po once

== Prevention ==

* Can do post-exposure prophylaxis with doxycycline 200 mg po once followed by 100 mg daily for 4 days

{{DISPLAYTITLE:''Borrelia recurrentis''}}
[[Category:Borrelioses]]