Tick-borne relapsing fever

Tick-borne relapsing fever (synonym: tick recurrent fever, tick spirochetes) - vector borne disease with severe natural focality.
Etiology. Pathogen - Spirochaeta sogdianum belonging to the genus Treponema, has the form of a spiral with 8-10 MK. Described 20 species spirohet, close to each other and causing tick-borne relapsing fever in various endemic areas of the globe. Pallidum is in the patient's blood as during the attack and in the interictal period. Pallidum tick return typhoid pathogenic for Guinea pigs.
Epidemiology. Reservoir and vector of the pathogen are mites of the genus Ornithodorus parasitizing on small mouse-like rodents and insectivorous animals and transmission of the pathogen through the bite of another animal, human, and transovarial.
Spirochetes are with infected blood in the stomach tick, then in the ovaries, coxalgia gland, salivary gland, defecation. Infection occurs when the tick bite. Susceptibility to disease is 100%. For tick-borne return of typhoid fever is characterized by seasonality associated with the activity of the carrier. Endemic foci of the disease are found almost on all continents. In the USSR in Central Asia, the Caucasus, the Caucasus, Kazakhstan, Stavropol region, Ukraine.
Pathogenesis and pathological anatomy tick return typhoid are the same as in the relapsing fever. More than a mild case of the disease due to less toxic degradation products spirochaete tick return of typhus.
Immunity in the population of endemic districts occurs in childhood and supported the re-introduction of the spirochaetes ticks, so are mostly newcomers. Termination natural immunization leads to re disease.
Clinical presentation and course. The disease occurs after the tick bite. On the site of the bite is formed itchy crimson papule that takes 2-4 weeks. The incubation period of 4 to 15 days. Beginning acute. The temperature rises with chills up 39-409. In addition to the General phenomena of weakness, weakness, lethargy, lack of appetite, insomnia, there are sharp headaches and pains in muscles of lower limbs. Pulse quickens, heart tones are deaf persons, systolic murmur at the top. Language white furred. Face red in the beginning, then fades and gets subcarinal color. The liver and spleen are enlarged, but to a lesser extent than with lousy In a recurrent fever. In the blood hypochromic anemia.
The observed during the attack neutrophilic leucocytosis and lymphopenia are changing in the period of apyrexia leukopenia with relative limfotsitoz. ROE is accelerated, reaching for the 2nd week of 40-60 mm/hour, and reduced by the end of the disease. Often during the attack are nonsense, stiff neck. First febrile seizure lasts for 1-4 days. The critical temperature falls. The duration of apyrexia 1-4 days. Sometimes 3-8 and more relapses, the duration of which progressively reduced up to 3-4 hours and periods of apyrexia extended, reaching 8-18 days or more, during which patients feel perfectly healthy. The disease lasts for 2 - 3 months or more.
Complications are rare; this is iridotsiklity, irity, vitreous opacity, rarely, meningitis, paraplegia, hemiparesis, and the defeat of the front, visual, auditory nerves.
The diagnosis. The disease is strictly endemic. Important discovery papules on the site of a tick bite. Laboratory diagnosis is carried out as and when lousy recurrent fever (see). In addition, use a biological sample (infection of Guinea pigs blood of patients). The differential diagnosis spend with malaria, lousy return typhoid, brucellosis, sepsis, fever mosquito (see articles about the diseases).
The prognosis is favorable.
Treatment. We recommend penicillin 200 000-250 000 IU 5-6 times a day for 5-6 days, tetracycline 0.25 g 4 times a day for 5-6 days, Albaicin 3 000 000 IU subcutaneously or intramuscularly 2 times a day for 7 to 12 days, biomitsin 200 000 IU 4 times a day for 5 days, streptomycin 0.5 g 2 times a day for 5 days. In addition, appoint the cardiovascular (kordiamin 1 ml subcutaneously 1-2 times a day), symptomatic treatment.
Prevention. Protection from tick bites (special clothes, bed curtains, repellents , and so on). Destroy ticks in residential and commercial buildings (DDT, hexachloran in the form of aerosols, Farrukh Dustov, checkers, emulsions). Insecticide treatments of animals (see Disinsection).