National Center for Global Health and Medicine, Disease Control and Prevention Center, Shinjuku-ku, Tokyo, Japan.
Am J Trop Med Hyg. 2013 Sep;89(3):460-1. doi: 10.4269/ajtmh.13-0187. Epub 2013 Jul 15.
Tick-borne relapsing fever (TBRF) is endemic in discrete areas throughout the world; however, a domestic or imported case of relapsing fever has not been reported in Japan. Here, we report the first imported case. A previously healthy 20-year-old woman presented to our hospital on October 8, 2010, because of recurrent fever and lower leg pain. Before consultation, she had experienced four febrile episodes at 10-12-day intervals after returning from her stay in Uzbekistan from 1 to 8 September. Giemsa stain of peripheral blood showed Borrelia spirochetes. The spirochete was identified as Borrelia persica by sequencing of the amplicons of flaB using polymerase chain reaction and phylogenetic analysis. The patient was diagnosed with TBRF, and she completed a 10-day course of minocycline 100 mg twice daily. After treatment, her periodic fever subsided. Physicians should be aware of TBRF in patients with recurrent fever who have returned from TBRF-endemic countries, including areas of the former USSR.
蜱传回归热（TBRF）在世界上许多地区呈地方性流行；然而，在日本尚未报告过本地或输入性回归热病例。在此，我们报告首例输入性病例。一名既往健康的 20 岁女性于 2010 年 10 月 8 日因反复发热和小腿疼痛就诊于我院。在就诊前，她于 9 月 1 日至 8 日从乌兹别克斯坦返回后每 10-12 天出现 4 次发热。外周血吉姆萨染色显示螺旋体。通过聚合酶链反应和系统发育分析扩增 flaB 序列鉴定螺旋体为波斯螺旋体。患者被诊断为 TBRF，并接受了为期 10 天的米诺环素 100mg，每日 2 次治疗。治疗后，其周期性发热消退。对于来自 TBRF 流行地区（包括前苏联地区）的反复发热患者，医生应注意 TBRF。
