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Background: <p>Louse-borne relapsing fever (LBRF) is a prevalent disease in Ethiopia, affecting malnourished and impoverished populations. Historically fatal, mortality has decreased to less than 5% with antibiotics. Symptoms include high fever, rigors, myalgia, hepatosplenomegaly, jaundice, and petechial rash. Diagnosis is challenging due to Giemsa-stained blood films and PCR in resource-limited settings. </p> Case Presentation: <p>A 29-year-old Ethiopian patient experienced abdominal pain, vomiting, diarrhea, and high fever for 3 days. Physical examination revealed low blood pressure, oxygen saturation, tachycardia, decreased air entry, and a tender abdomen. A bedside ultrasound revealed bilateral pleural collection, dense B lines, an air bronchogram, and abdominal collection. The patient had thrombocytopenia, leukocytosis, acute kidney injury, elevated transaminase levels, and Borrelia spirochetes in her blood. The patient recovered fully within 8 days after respiratory failure. </p> Discussion: <p>This case highlights the importance of recognizing relapsing fever (RF) as a critical mimic of surgical abdomen, preventing unnecessary surgical interventions in hemorrhagic abdominal emergencies.</p> Conclusion: <p>A life-threatening Borrelia-induced hemoperitoneum in Ethiopia was successfully managed, despite complications of surgical acute abdomen with hemoperitoneum, severe thrombocytopenia, and multiorgan involvement, highlighting the importance of infectious consideration in acute abdomen.</p>

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Unusual presentation of complicated relapsing fever with spontaneous hemoperitoneum mimicking surgical acute abdomen: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月17日

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  • Yemane Gebremedhin Tesfay,
  • Habtamu Kebede Adera,
  • Zelalem Getahun Demissie,
  • Dirijit Mamo Alemu,
  • Menbeu Sultan Mohammed,
  • Getaw Worku Hassen,
  • Mohammed Kalifa Nuguse

摘要

Background:

Louse-borne relapsing fever (LBRF) is a prevalent disease in Ethiopia, affecting malnourished and impoverished populations. Historically fatal, mortality has decreased to less than 5% with antibiotics. Symptoms include high fever, rigors, myalgia, hepatosplenomegaly, jaundice, and petechial rash. Diagnosis is challenging due to Giemsa-stained blood films and PCR in resource-limited settings.

Case Presentation:

A 29-year-old Ethiopian patient experienced abdominal pain, vomiting, diarrhea, and high fever for 3 days. Physical examination revealed low blood pressure, oxygen saturation, tachycardia, decreased air entry, and a tender abdomen. A bedside ultrasound revealed bilateral pleural collection, dense B lines, an air bronchogram, and abdominal collection. The patient had thrombocytopenia, leukocytosis, acute kidney injury, elevated transaminase levels, and Borrelia spirochetes in her blood. The patient recovered fully within 8 days after respiratory failure.

Discussion:

This case highlights the importance of recognizing relapsing fever (RF) as a critical mimic of surgical abdomen, preventing unnecessary surgical interventions in hemorrhagic abdominal emergencies.

Conclusion:

A life-threatening Borrelia-induced hemoperitoneum in Ethiopia was successfully managed, despite complications of surgical acute abdomen with hemoperitoneum, severe thrombocytopenia, and multiorgan involvement, highlighting the importance of infectious consideration in acute abdomen.