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The page below is a sample from the LabCE course Tickborne Diseases. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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TBRF Timeline/CDC

Tickborne Relapsing Fever (TBRF): Clinical Manifestations

Typical acute febrile periods followed by remission are seen in this disease. This happens in patients because these species of Borrelia can undergo DNA rearrangement and systematically change their surface antigens. Therefore, antibodies made to the previous antigens are no longer effective. The organism and fevers may recur causing relapsing episodes
The fever typically lasts 3 to 4 days. Then there is an interval without fever averaging 7 days. Episodes of fever are less severe with each recurring episode. Relapses can occur one to four times. Patients also report headaches with body, muscle, and joint pains. Nausea, vomiting, and anorexia can be found as well, along with a dry cough, sensitivity to light, neck pain, eye pain, confusion, and dizziness.
General laboratory values include:
  • Mild leukocytosis
  • Elevated erythrocyte sedimentation rate (ESR)
  • Anemia
  • Thrombocytopenia (eg, < 50,000 platelets per mm3)
  • Increased serum unconjugated bilirubin levels
  • Increased aminotransferase levels
  • Prolonged prothrombin time (PT) and partial thromboplastin time (PTT)
  • Proteinuria and microhematuria