Cases reported "Relapsing Fever"

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1/2. relapsing fever and its serological discrimination from Lyme borreliosis.

    patients with Borrelia-caused relapsing fever produce cross-reacting antibodies to borrelia burgdorferi, the anti-genetically related causative agent of Lyme borreliosis. The antibody response of the serum of a patient (acute and convalescent) with relapsing fever was analysed by the immunoblot technique using Borrelia hermsii and B. burgdorferi as antigens. The diagnosis was established by microscopic detection of spirochetes in the patient's blood. The patient's serum showed significantly elevated titers of IgG and IgM in a B. burgdorferi indirect immunofluorescence assay. Immunoblot analysis indicated the presence of cross-reacting antibodies directed to B. burgdorferi antigens with apparent molecular weights of 60, 41, 40, 36, 30 and 20 kDa.
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2/2. Detection of Borrelia in acridine orange-stained blood smears by fluorescence microscopy.

    Tick-borne borreliosis (relapsing fever) can be an important, unsuspected cause of febrile illness. The diagnosis is generally made by identifying Borrelia spirochetes in stained peripheral blood smears. Since Borrelia may be difficult to detect with Romanowsky stains, an alternative method, using acridine orange (AO), was used to screen blood smears. Duplicate blood smears of seven patients were examined with the AO technique and Romanowsky stains. In all seven cases spirochetes were easily identified with the AO-stained smears compared with only five cases with Romanowsky stains. In a double-blind laboratory experiment, six of ten duplicate smears from a single patient with mild spirochetemia were positive by AO, whereas only two of ten were positive by Romanowsky stain. We concluded that the AO stain is simple, rapid and more sensitive than Romanowsky methods for detecting cases of low-level spirochetemia.
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