The world recurring fever ( FRM ) is a Infectious illness due to a Bactérie of the Borrelia transmitted by the Pou X, which prevails hardly than in Ethiopia and with the Sudan.

Causal agent and transmission

The borrélies are Spirochète S. the agent of the FRM, Borrelia recurrentis , is transmitted to the human being by the lice of the body, more rarely by the lice of head. The louse contaminates itself by pricking a patient in feverish phase. The bacterium multiplies quickly in the general cavity of the louse. The puncture and the dejections of the louse, curiously, are not contaminant. The contamination is made on the level cutaneous Excoriation S or at the conjunctival level during the crushing of a louse, releasing the coelomic liquid, rich in borrélies. Charles Vialatte, Henry Foley and Edmond Sergent contributed to discovered role of the louse in the transmission of the world recurring fever during the years 1923 - 1925.

Groups at the risk

It can exist epidemic pushes at the time of war or tranfert of population, because these events support the pullulation of the lice and decrease the resistance of the populations.

Private clinic

Incubation

2 to 8 days

Beginning

The beginning is extremely abrupt with Fièvre with 40-41 °C, shivers, Algie S diffuse, congestion of the face and conjunctival injection .

Phase of state

The phase of state consists of an alternation of feverish and apyretic phases. The feverish first phase lasts one week, the fever is in plate with 40 °C. There are Céphalée S, digestive disorders, a Splénomégalie and sometimes a Hépatomégalie. At the 7th day, the general signs regress abruptly with sweat crisis and urinary, then 8 days of Apyrexie with Asthénie. In the absence of treatment, the fever returns identical, but only from 3 to 5 days. There is often a second recurrence, 1 week afterwards.

Pathogenesis

The fever occurs at the time of the Bactériémie S. the apyrexie corresponds to the sequestration of the bacterium in the deep bodies.

Diagnosis

The diagnosis is clinical. One is also directed by the blood test, which shows neutrophilie, Anémie and hepatic Cytolyse. The diagnosis is certain when the bacterium is seen under the microscope when blood is observed under the microscope at black bottom or after coloring of blood to the Indian ink.

Differential diagnoses

It is systematically necessary to consider that the symptoms can be those, non-pas of a FRM, but of a Paludisme, a Salmonellose, a Leptospirose, a Hépatite, a Typhus or a Arbovirose.

Forecast

Without treatment, 40% of mortality by Hépatonéphrite serious mortal. With treatment, mortality goes down to 5%. On the other hand, the treatment always does not prevent the ocular complications, which are rather frequent: Iritis, Iridocyclitis, optical Neuritis.

Treatment

5 to 10 days of Tétracycline or béta-lactamine or Macrolide. At the beginning of the treatment, a Réaction of Jarisch-Herxheimer can occur (reaction allergic to the corpses of the killed bacteria).

Prevention and monitoring

The Forty formerly is not any more rigor. However, it is necessary to isolate the patient during the 1st week and the épouiller (DDT or other Insecticide on the body and clothing).

Related diseases

The regional recurring fevers with tick are many, and also due to borrélies.

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