184.4 📌 章末速蚘

  • LBRF (B. recurrentis): body louse, refugee/war, 10-40% mortality, severe Herxheimer
  • TBRF (multiple species): soft tick (Ornithodoros), W USA cabin/cave, 5-10 relapses
  • B. miyamotoi: hard tick Ixodes (Lyme area), single episode usually
  • Cycles due antigenic variation Vmp
  • Peripheral smear visible spirochete — unique
  • Treatment: doxycycline 100 bid × 7-10d (TBRF), single dose (LBRF)
  • Severe / CNS: ceftriaxone 2 g IV × 14d
  • Jarisch-Herxheimer severe (LBRF) → ICU monitoring
  • Refugee / cabin / cave exposure history
  • 鑑別 malaria (cyclic fever + travel hx)