Subject(s)
Bacterial Proteins/blood , Relapsing Fever/diagnosis , Serologic Tests/methods , Animals , Anti-Bacterial Agents/therapeutic use , Bites and Stings , Borrelia/drug effects , Doxycycline/therapeutic use , Female , Fever/diagnosis , Fever/etiology , Humans , Mexico , Middle Aged , Relapsing Fever/blood , Relapsing Fever/drug therapy , Retrospective Studies , Ticks/microbiologyABSTRACT
A 26-year-old woman presented with a 2-day history of fever peaking to 39 degrees C and cold shivers that developed after a 2-weeks trip to Guatemala and Belize. Prior to the fever the patient had felt symptoms of a common cold and general malaise. Moreover, she complained of generalised myalgia and nausea. She had taken paludrine as a prophylactic against malaria. Borrelia spirochaetes, the pathogen of relapsing fever, were detected in a thick blood smear preparation. On the basis of the anamnesis, geography and specific exposure, the patient had a form of relapsing fever that is transmitted by ticks and not by lice: tick-borne relapsing fever. She was treated with doxycycline, 100 mg b.i.d. for 7 days. She could be discharged home in good condition after 2 days.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Borrelia/isolation & purification , Doxycycline/therapeutic use , Relapsing Fever/diagnosis , Travel , Adult , Belize , Female , Guatemala , Humans , Relapsing Fever/blood , Relapsing Fever/drug therapy , Treatment Outcome , Tropical ClimateABSTRACT
Typhus and other louse-transmitted bacterial infections in Peruvian sierra communities are known to occur but have not recently been assessed. In this study, 194 of 1,280 inhabitants of four villages in Calca Province in the Urubamba Valley were included. Thirty-nine (20%) of the 194 volunteers had antibodies to Rickettsia prowazekii, whereas 24 (12%) had antibodies to Bartonella quintana and 2 against Borrelia recurrentis. There was a significant correlation between the presence of infesting ectoparasites and antibodies to R. prowazekii, as well as between antibodies to R. prowazekii and ectoparasite infestation and fever in the previous 6 months. The proportion of inhabitants infested with ectoparasites was significantly higher in the highest-altitude village than in the other three villages. Two volunteers' antibody levels suggested a recent typhus infection, but only B. quintana DNA was amplified from lice. Epidemic typhus remains extant in the area, and B. quintana infections were encountered and documented for the first time in South America.