• Causative organism: members of the genus Borrelia
• 致病菌：莱姆菌系
◦ Louse Borne Relapsing Fever (LBRF)
◦ 虱子传播的回归热（LBRF）
▪ Human body louse (Pediculushumanus)
▪ 人体虱（Pediculushumanus)
▪ Associated with sporadic outbreaks especially in areas with large refugee populations
▪ 与散在的爆发有关，尤其在难民多的地区
◦ Tick Borne Relapsing Fever (TBRF)
◦ 蜱传播的回归热（TBRF）
▪ Soft ticks of the genus Ornithodoros
▪ 软蜱族，纯绿蜱属 （Ornithodoros)
▪ Typically found in higher elevations of the western United States as well as the central plateau region of Mexico, Central and South America and Africa
▪ 主要在美国西部的高海拔地带和墨西哥，中南美及非洲的中心平原地带
• Clinical Presentation
• 临床表现
◦ Symptoms develop 3 to 18 days after infection.
◦ 症状在感染后3－18天出现
◦ Onset is abrupt and may include fever, malaise, headache, arthralgias, nausea and vomiting and cough.
◦ 症状常突然出现，包括：发烧，乏力，头疼，关节痛，恶心，呕吐，咳嗽
◦ The first febrile episode lasts 3 to 6 days and then recurrences may occur after 7 to 10 days.
◦ 第一次发烧期持续3－6天，常在7－10天后复发
• Diagnosis
• 诊断
◦ Definitive diagnosis: visualization of spirochetes on peripheral blood smear.
◦ 确诊：末梢血中查到螺旋体
◦ May also see leukocytosis, anemia and/or thrombocytopenia, elevation of liver function tests
◦ 可出现：白血球增高，贫血，血小板低，肝功能异常
◦ Erythrocyte rosette formation may be present.
◦ 红细胞花环形成
• Treatment
• 治疗
◦ Antibiotics recommended for treatment include penicillin, doxycycline and erythromycin.
◦ 抗菌素：青霉素，四环素，红霉素
◦ Jarisch-Herxheimer reaction common after treatment. This can be life threatening and all patients undergoing treatment should be closely monitored.
◦ 治疗后常会出现Jarisch-Herxheimer反应，可危及生命，因此要对治疗中的病人进行密切观察
University of Maryland Section for Global Emergency Health
马里兰大学全球急诊健康医学部
Author作者: Gentry Wilkerson
References参考文献
1. Centers for Disease Control and Prevention CDC. Tickborne relapsing fever in a mother and newborn child--Colorado, 2011. MMWR Morb Mortal Wkly Rep. 2012;61(10):174–176.
2. Larsson C, Andersson M, Bergström S. Current issues in relapsing fever. CurrOpin Infect Dis. 2009;22(5):443–449.

Translation: Feng Xiao
翻译：肖锋