PMC3336251_01
Loosely coiled Borrelia sp. in a thin peripheral blood smear stained with Wright-Giemsa stain and visualized under oil immersion (x500).
CRIM.ID2011-950314.001.jpg
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fig1
She had a heart rate of 145 bpm and a systolic blood pressure of 140 mmHg (Figure 1). The patient's temperature, blood pressure, and platelet count decreased rapidly (Figure 1).
Time course of Jarisch-Herxheimer reaction (J-HR) in relapsing fever. Antimicrobial therapy was started at time 0. Symptoms of rapid decrease in temperature, hypotension, and thrombocytopenia correlated with peripheral blood spirochete clearance (pattern). Sepsis resulted in elevated serum cardiac troponin without acute coronary syndrome at 36 and 48 hours compared to time 0.
CRIM.ID2011-950314.002.jpg
PMC3336251_01_CRIM.ID2011-950314.002.jpg
fig2
Microscopic examination of the peripheral blood smear revealed numerous loosely-coiled spirochetes consistent with Borrelia sp. infection (Figure 2).