Relapsing fever - Treatment

Alternative Names

Tick-borne relapsing fever, Louse-borne relapsing fever

Treatment:

Treatment involves antibiotics, most often tetracycline, doxycycline, erythromycin, or penicillin.

Expectations (prognosis):

The death rate for untreated LBRF ranges from 10 - 70%. In TBRF, it is 4 -10%. With early treatment, the death rate is reduced. Those who have developed coma, myocarditis, liver problems, or pneumonia are more likely to die.

Complications:

Coma
Facial droop
Liver dysfunction
Meningitis
Myocarditis -- may lead to arrhythmias
Pneumonia
Seizures
Shock related to taking antibiotics (Jarisch - Herxheimer's reaction, in which the rapid death of very large numbers of Borrelia organisms induces shock)
Weakness
Widespread bleeding

Calling your health care provider:

Notify your medical provider if you are a returning traveler and you develop fever -- there are many different possible infections that will need to be investigated in a timely manner.

Reviewed last on: 12/10/2010
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Petri WA. Relapsing fever and other Borrelia infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 343.

Rhee KY, Johnson WD Jr. Borrelia species (relapsing fever). In: Mandell GL, Bennett JE, Dolan R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Orlando, FL: Saunders Elsevier; 2009:chap 241.

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