infectious diseases
Relapsing Fever
Treatment of Relapsing Fever
Tetracycline,doxycycline,erythromycin, orprocaine penicillin G Inrelapsing fever transmitted by ticks,tetracyclineorerythromycin500 mg orally every 6 hours ordoxycycline100 mg orally every 12 hours is given for 10 days. Forlouse-transmitted relapsing fever,a single 500-mg oral dose oftetracyclineorerythromycin, a single 200-mg oral dose ofdoxycycline, or a single dose of procainepenicillin G400,000 to 800,000 units IM is effective. Children<8 years of age are givenerythromycinestolate 10 mg/kg orally 3 times a day. When vomiting or severe disease precludes oral administration or when the central nervous system is affected, parenteralceftriaxone2 g once a day or 1 g every 12 hours for 10 to 14 days,doxycycline1 to 2 mg/kg IV every 12 to 24 hours, orpenicillin G3 million units IV every 4 hours may be given to adults or children>8 years of age. Children<8 years are givenpenicillin G25,000 units/kg IV every 6 hours. Therapy should be started early during fever. A Jarisch-Herxheimer reaction (JHR) may occur within 2 hours of starting therapy. Severity of the Jarisch-Herxheimer reaction may be lessened by giving Dehydration and electrolyte imbalance should be corrected with parenteral fluids. Acetaminophenwithoxycodoneorhydrocodonemay be used for severe headache. Nausea and vomiting should be treated withprochlorperazine5 to 10 mg orally or IM once a day to 4 times a day. If heart failure occurs, specific therapy is indicated. 