Louse-borne relapsing fever

Diseases which will probably be subject to control by insecticides but have not yet been adequately tested include sandfly fever, dengue, urban yellow fever, bartonellosis, cutaneous leishmaniasis, Chagas disease, filariasis, trench fever, and louse-born relapsing fever. Some of the virus encephalitides. sleeping sickness, and visceral leishmaniasis may also be susceptible of control. 

Suggested Alternatives for Differential Diagnosis Acanthamoeba, louse-borne relapsing fever, dengue fever, Rift Valley fever, hemorrhagic fevers, leptospirosis, malaria, typhoid fever, typhus, liver failure, and hepatitis. 

W8. Warrell, D. A., Perine, P. L., Krause, D. W., Bing, D. H., and McDougal, J. S., Pathophysiology and immunology of the Jarisch-Herxeimer-like reaction in louse-borne relapsing fever Comparison of tetracycline and slow-release penicillin. J. Infect. Dis. 147, 898-909 (1983). 

Perine PL, Teklu B. Antibiotic treatment of louse-borne relapsing fever in Ethiopia a report of 377 cases. Am J Trop Med Hyg 1983 32(5) 1096-100. 

The Jarisch-Herxheimer reaction is common in patients treated with tetracyclines for louse-borne relapsing fever (43). Two forms of reaction are described at the start of tetracycline therapy (a) fever, rigor, increased respiratory and heart rates, and occasional delirium and coma (44) (b) fever and disseminated intravascular coagulation (45). At about the time the temperature reaches its peak, spirochetes disappear from the peripheral blood (44). Meptazinol, a partial opioid antagonist, reduces the Jarisch-Herxheimer reaction in relapsing fever (46). 

Bleeding with thrombocytopenia and signs of intravascular coagulation in patients treated for louse-borne relapsing fever may be due to a Jarisch-Herxheimer reaction mediated by the release of endotoxins from disintegrating spirochetes (43). 

Zein ZA. Louse borne relapsing fever (LBRF) mortality and frequency of Jarisch-Herxheimer reaction. J R Soc Health 1987 107(4) 146-7. 

Bryceson AD, Parry EH, Perine PL, Warrell DA, Vukotich D, Leithead CS. Louse-borne relapsing fever. Q J Med 1970 39(153) 129-70. 

Perine PL, Kidan TG, Warrell DA, Bryceson AD, Parry EH. Bleeding in louse-borne relapsing fever. II. Fibrinolysis following treatment. Trans R Soc Trop Med Hyg 1971 65(6) 782-7. 

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