Lange W R, Schwan T G, Frame J D
Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Med Hypotheses. 1991 Jun;35(2):77-9. doi: 10.1016/0306-9877(91)90026-u.
We report the case of a Protestant missionary who contracted tick-borne relapsing fever in 1979 while serving in the Sudan. Despite tetracycline treatment, his acute illness ran a protracted course, with migratory polyarthralgias lasting approximately 10 months. Symptoms recurred in 1984 and have persisted. At regular intervals, the patient has experienced recurrent episodes of fever, generalized fatigue, bilateral upper and lower extremity muscle weakness, and asymetric large joint polyarthralgia. Indirect fluorescent antibody testing of sera demonstrated titers of 1:16 for B. burgdorferi and 1:64 for B. hermsii, and immunoblotting confirmed past exposure to relapsing fever, but not Lyme disease. It is hypothesized that this individual's chronic symptoms have been related to relapsing fever, and that in certain situations or in select individuals, relapsing fever can be capable of producing a chronic clinical picture analogous to Lyme disease.
我们报告了一例新教传教士的病例，该传教士于1979年在苏丹服务期间感染了蜱传回归热。尽管接受了四环素治疗，他的急性疾病病程迁延，游走性多关节痛持续了约10个月。症状于1984年复发并一直持续。患者定期出现发热、全身疲劳、双侧上下肢肌肉无力以及不对称大关节多关节痛的反复发作。血清间接荧光抗体检测显示，伯氏疏螺旋体滴度为1:16，赫氏疏螺旋体滴度为1:64，免疫印迹证实既往感染过回归热，但未感染莱姆病。据推测，该个体的慢性症状与回归热有关，并且在某些情况下或特定个体中，回归热能够产生类似于莱姆病的慢性临床表现。
