Relapsing fever

• sudden onset of high fever
• rigors
• headache; neck stiffness
• nausea
• vomiting
• muscle aches (myalgia)
• joint aches (arthralgia)
• bleeding
• seizures
• unsteady gait
• facial droop
• coma
• weakness

Relapsing fever should be suspected in someone coming from an endemic area who has repeated episodes of fever, particularly if fever is followed by a "crisis" stage, and if the person thinks they may have been exposed to lice or soft-bodied ticks.

A blood smear is frequently obtained to see if the organism is present. A culture for this organism is not widely available in most laboratories. Certain blood antibody tests are sometimes used.

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