Volume 22, Number 2—February 2016
Dispatch
Louseborne Relapsing Fever among East African Refugees, Italy, 2015
Table
Characteristics of louseborne relapsing fever among East African refugees, Italy, 2015*
Characteristic | Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 |
---|---|---|---|---|---|
Time from arrival in Italy | 3 d | 4 y | 3 y | 10 d | 10 d |
Age, y | 20 | 27 | 31 | 20 | 26 |
Date of admission | Jun 9 | Jul 28 | Sept 5 | Oct 1 | Sept 29 |
Date of symptom onset |
Jun 7 |
Jul 24 |
Sept 1 |
Sept 27 |
Sept 26 |
Symptom | |||||
Fever | Yes | Yes | Yes | Yes | Yes |
Abdominal pain | No | No | Yes | Yes | No |
Vomiting | Yes | Yes | Yes | Yes | No |
Diarrhea | No | No | Yes | No | No |
Headache | Yes | Yes | Yes | Yes | Yes |
Myalgia | No | Yes | No | No | Yes |
Other |
None |
Lumbar pain |
None |
Cough |
Chest pain, itching |
Laboratory test (reference) | |||||
Platelets (>150,000/μL) | 32,000 | 47,000 | 22,000 | 41,000 | 2,9000 |
Bilirubin (<1.2 mg/dL) | 2.3 | 1.8 | 3.9 | 4.2 | 1.8 |
Liver function† | Normal | Normal | AST ×4; ALT ×3 | AST ×3; ALT normal | Normal |
Prothrombin time (>70%) | 78% | 66% | 68% | 100% | 70% |
CRP† | ×16 | ×56 | ×95 | ×115 | ×59 |
Procalcitonin (<0.5) | 11.36 | NA | 21 | 11.9 | NA |
QTc (<440 msec) | 428 | 361 | 423 | 391 | 414 |
PCR for Borrelia recurrentis |
Positive |
Positive |
Positive |
Positive |
Positive |
Treatment | Doxycicline | Doxycicline | Doxycicline | Doxicicline + ceftriaxone | Doxycicline, switched to ceftriaxone |
Jarisch-Herxheimer reaction | Yes, mild | Not observed | Not observed | Not observed | Yes, moderate |
*ALT, alanine aminotransferase; AST, aspartate aminotransferase; CRP, C-reactive protein; NA, not available; QTc, corrected QT interval.
†Indicated as normal (within reference value) or × upper reference value.