تب راجعه

Liver abscesses are the most common type of visceral abscess. The rare cases of liver abscess caused by infection with F. hepatica has been reported. F. hepatica is Liver trematode common to humans and animals. F. hepatica have global emission and common in temperate, hot and humid zones, and especially in areas where livestock farming is common in them are widespread. In this case report a patient with liver abscess caused by F. hepatica infection is reported.
Case Report: this Report related patient with primary diagnosis liver abscess and get medication for liver abscess, But does not improve and refer by relapsing fever. After radiological studies and positive serology for Fasciola hepatica under the treatment of fascioliasis, in follow up the fever and liver lesion disappear.
Given that the new focus F. hepatica infection have been reported in southern Iran, in the all cases with fever and liver abscess in this geographic areas, F. hepatica considered in the differential diagnosis

Borreliosis or recurrent fever is a spirochete disease which is caused by various species of borrelia and characterized by recurrent episodes of fever, chills and spirochetemia that could lead to multiple organ involvement and even death. In this case report, a 23 years old man was presented with shaking chills, fever and abdominal pain from a week before hospital admission. Borrliosis was confirmed following observation of Spirochete in peripheral blood smear. The patient was treated with doxycycline orally and one week after treatment discharged with a good general condition. Coincidence of borreliosis with underlying haemolysis in this patient was misled clinical presentation.

Ticks are the main arthropods that play an important role in disease transmission to human beings. They are also important in zoonosis. One of the most important diseases transmitted by soft ticks is relapsing fever and its causative agent, Borrelia persica, could be transmitted by O.tholozani. The disease transmission routes are mainly through tick bites, as well as coxal fluids. In the year 2003 a total of 36 Borreliasis cases were reported in Kurdistan Province, from which 95% were from Bijar Town. In the study area a total of 20 villages were selected randomly. The study was conducted between winter 2002 and autumn 2003. Ticks were collected in each season once. In each village 5 sites were chosen randomly as representatives of resting places of ticks. In each place ticks were collected by the hand collection method for a standard 20 minutes. All required information about the specimens was recorded in holding tubes of the ticks. Subsequently ticks were identified using the national systematic key. In order to find the infectivity of O.tholozani to B.persica, the ticks were smashed in a proper way and then suspensions were injected into Guiana pigs and mice. From day 4 onwards for 10 days the animal's blood were examined under microscope for presence of Borrelia in the blood smear. All the information was subjected to the statistical analysis and results were then interpreted. During the entire period of the study a total of 8,537 soft ticks were collected. The ticks were identified in two genera, Argas (45.7%) and Ornithodoros (54.3%). Ornithodorus comprises of two species: Ornithodoros lahorenis with a maximum of 47.6% and Ornithodoros tholozani with a maximum of 6.7%. Argas includes Argas persicus (45.7%) and Argas refelxus with a minimum of 0.07%. Collected O.tholozani was tested for their infection with Borrelia persica. Among all the specimens tested only 3% were shown to be infected with this agent. This infection was only found in spring and summer. Our findings support the presence of disease in the study area. It should be emphasized that the peak of tick activity is synchronized with disease burden. The disease is found in Golbalagh village, Siah Mansoor region. This region is situated in vicinity of Takab City which was previously reported as an endemic area of Borreliasis.

Ardabil province is the main area of Iran affected by relapsing fever (RF) for which Borrelia Persica is the most common cause. The aim of this study was to determine the epidemiologic characteristics of the disease, and the frequency of infection among ticks in this region in order to take necessary measures to decrease it is incidence and increase awareness about the characteristics of this disease. In this study a total of 391 patients who were diagnosed to have been effected by tick borne relapsing fever were investigatated in terms of clinical epidemiology between 1998 and 2001. The kind of Borrelia as well as the clinical characteristics of the disease were observed. The kind and prevalence of Borrelia infection was determined in 1,421 ticks collected from 130 indoor and 14 outdoor sites. The ticks were crushed and the suspension obtained was injected into the peritoneum of two mice and two guinea pigs to determine the frequency of infection among the ticks living in this region. Data including the tick species determination were collected through a questionnaire and analyzed using Chi-square and ANOVA tests. The most prevalent clinical manifestations were fever, chills and headache. Other findings included nausea, vomiting, sweating, abdominal pain, arthralgia, cough, photophobia, eosinophilia, hematuria, jaundice, petechiae and sclera congestion. Laboratory tests performed on 60 patients showed leukocytosis, high erythrocyte sedimentation rate (ESR) and anemia. Of the 1,421 ticks collected, 45.9%, 40.3% and 13.8% were infected by Ornithodoros lahorensis Ornithodoros tholozani and Argas persicus species, respectively. The prevalence of ticks was highest in Khanadabil village. The ticks collected from three villages were found to be infected with Borrelia. The clinical manifestations were similar to those reported in other studies. Petechiae occurred less frequently in our study compared to louse-borne RF. The high frequency of anemia in this region, which was not stated in other reference articles, requires further investigation.