Diagnosis and Treatment of Relapsing Fever

Relapsing Fever is an infection caused by several bacteria in the genus Borrelia. This is a vector-borne disease that is transmitted through fleas or soft-bodied tick bite.
Basic Abnormalities: Borrelia endotoxin damage organs (spleen, liver, kidney tubules, lung alveoli and cerebrum) to cause DIC (clots in blood vessels overall) and the activation of the complement system that interfere with hemodynamics during Jarisch-Herxheimer reaction occurs post-therapy.
I. Diagnosis
Incubation period: 3-18 days
A. Main complaint

    * Sudden high fever (39-40 degrees C)
    * Chills
    * Sefalgi great
    * Mialgi and artralgi
    * Abdominal pain upper
    * Anoreksi, vomiting
    * Malese
    Nonproductive cough *
    * The attack stopped suddenly after 3 days, 1-2 weeks of remission, then relapse again, but milder clinical picture.
B. Main sign

    * Tachycardia
    * Meningismus
    * Delirium
    * Mental Disorders
    * Depression
    * Hepatosplenomegaly
    * Jaundice
    * The signs of bleeding
    * Fotofobis, iritis, iridosiklitis
C. Laboratory examination

    * There is no typical
    * Smear of peripheral blood to see Spirokaeta
    * Preparations for the dark field
    * Blood tests rat pups after inoculation of blood or tissue of the patient.
D. Special Inspection

    * Elektrokardiagrafi: QT interval length
    * There was an agglutination reaction with Ag OXK proteus.
II. Complication

    * Blind permanent
    * Damage hepatocellular
    * Bleeding
III. Management
A. General Therapy

    * Rest
      - Rest in hospital
      - Fluid perinfus supervised
    * Diet
    * Medical
      - Drugs first:
          o Tetracycline, 4 x 500 mg for 10 days
          o Deksosiklin, 2 x 100 mg
          o Erythromycin, 4 x 500 mg / day for 10 days
          o chloramphenicol, 4 x 500 mg / day

      - Alternative medicine
          o The combination of penicillin G IM procain first day, followed by tetracycline 30 mg / kg bw per oral / 4 divided doses for 7 days.
B. Therapy Complications: -
IV. Prognosis

    * Without treatment mortality of 30-70%, with only 1% therapy
    * High on Death:
      - Parents
      - Tuna mental
      - People with very young
    * Iritis and uveitis reduce visual acuity
    * Complications are rarely at:
      - Impaired airway
      - Nephritis
      - Endocarditis
      - CNS Disorders 

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