Relapsing fever is caused by arthropod-borne spirochetes of the genus Borrelia and is clinically characterized by recurrent episodes of fever and spirochetemia. The endemic form of the disease is transmitted by a tick of the genus Ornithodoros, which is widely distributed throughout the eastern and western hemispheres.1-3 The incubation period of the disease varies from two to ten days. The time of exposure may be difficult to establish since the tick bite may go unrecognized. The onset of the disease is usually sudden and associated with high fever and diffuse toxic symptoms. Treatment at this stage of the disease may be complicated by the Jarisch-Herxheimer reaction characterized by hypotension, cardiac failure, and possible
Small inflammatory nodule surrounded by zone of normal skin and circumferential brownish ring. death.1-3 The bite of the tick Ornithodoros tholozani results in a distinctive form of eruption called ornithodoriasis, which develops several hours after
Ronnen M, Kahana M, Schewach-Millet M. Ornithodoriasis Preceding Borrelia Infection. Arch Dermatol. 1984;120(11):1520–1521. doi:10.1001/archderm.1984.01650470126030
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