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Neonatal Relapsing Fever in Rwanda

Am J Dis Child. 1986;140(2):89. doi:10.1001/archpedi.1986.02140160007003.
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Sir.—We read with interest the article by Yagupsky and Moses1 on neonatal relapsing fever. We describe our experience with one case of neonatal Borrelia species infection in a Rwandese newborn and his favorable outcome under antimicrobial therapy.

Patient Report.—A 15-day-old male infant, weighing 2.900 kg, was hospitalized in the Centre Hospitalier de Kigali, Rwanda, for fever, jaundice, and purpura of two days' duration. On physical examination, the child was febrile (temperature, 38.5 °C), icteric, and floppy. His liver and spleen were palpable 3 cm below the costal margin. Purpura was observed on the abdomen and four limbs. His blood cell count was as follows: hemoglobin level, 11.7 g/dL; white blood cells, 17,100/cu mm; segmented neutrophils, 35%; lymphocytes, 52%; and monocytes, 13%. The serum glutamic-oxaloacetic transaminase level was 870 IU/L; the serum glutamic-pyruvic transaminase level was 690 IU/L. Cerebrospinal fluid was slightly hemorrhagic but otherwise normal. Blood culture


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