Tick-borne relapsing fever : An unrecognized cause of fever in travelers
Tick-borne relapsing fever is a usual cause of fever in West Africa. Except relapsing febrile episodes, there are no pathognomonic signs and diagnosis is difficult because Borrelia density in patient’s blood is low.
Tick-borne relapsing fever was revealed by the presence of spirochetes in a blood sample to search malaria in two men, 24 and 31 year-old, returned from Mali.
This diagnosis should be evocated in patients having fever after a trip in infested area, as malaria, both infections can be associated.
I got news for you. Borrelia density is low in many patients’ blood. This is a common problem and one of the reasons why patients continue to test negative.