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B. recurrentis causes relapsing fever—epidemic louse-borne andendemic tick-borne relapsing fever.
Clinical manifestations of epidemic louse-borne and endemic tick-borne relapsing fever are essentially similar. The incuba-tion period is usually 7 days. Two or more episodes of high fever, headache, and myalgia are the hallmarks of the disease. Splenomegaly and hepatomegaly are the associated symptoms. These symptoms correspond to the bacteremic phase of the disease when Borrelia is found in large numbers in patient’s blood (Fig. 44-4).
The fever subsides after 3–7 days when the Borrelia is cleared from the circulation. After an afebrile period of 4–7 days, bac-teremia occurs and fever reappears. The Borreliareappears in the blood during relapse of the fever. The condition ultimately subsides after 3–10 relapses.
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