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July 13, 1940


JAMA. 1940;115(2):125-126. doi:10.1001/jama.1940.72810280008009f

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Relapsing fever, a disease found with relative frequency in certain tropical countries, has been rarely observed in the United States. For this reason, a typical case observed in a Midwestern state is of interest.

A woman aged 40 when seen on Dec. 19, 1939, had been ill for about six weeks. Her illness was characterized by recurrent attacks of elevations of temperature and repeated chills. She had been under medical treatment throughout this time, having been treated symptomatically, chiefly with large doses of quinine. There had been no improvement.

On routine examination I found that agglutination tests with antigens from tularemia, typhoid and undulant fever were all negative. There were no abnormal urinary changes. All physical examinations were negative. When I examined the blood smears I found many spiral organisms present. These spirochetes were unusually long, with seven or eight spirals. They were attached to the border of the red

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