NEUROBORRELIOSIS DURING RELAPSING FEVER - REVIEW OF THE CLINICAL MANIFESTATIONS, PATHOLOGY, AND TREATMENT OF INFECTIONS IN HUMANS AND EXPERIMENTAL-ANIMALS

The spirochetal disease relapsing fever is caused by different Borreli a species. Relapsing fever is well recognized as an infection of the b lood, but little is known about its predilection for the nervous syste m and the eyes. To investigate neurological and ocular involvement dur ing relapsing fever, we reviewed the clinical manifestations, patholog y, and treatment of relapsing fever of humans and experimental animals . The results indicate that Borrelia turicatae and Borrelia duttonii, the agents of tick-borne relapsing fever in southwestern North America and sub-Saharan Africa, respectively, cause neurological involvement as often as Borrelia burgdorferi in Lyme disease. Evidence of this is the frequent occurrence of lymphocytic meningitis and peripheral facia l palsy in human disease; the identification of spirochetes in the bra in and other nervous tissues of humans, animals, and arthropod vectors ; and the persistence of brain infection after treatment with antibiot ics that do not readily penetrate the blood-brain barrier.