Relapsing fever physical examination

Overview
Most people who are infected get sick around 5-15 days after they are bitten by the tick. The symptoms may include a sudden fever, chills, headaches, and muscle or joint aches, arthralgias, sweats and nausea; a rash may also occur. These symptoms continue for 2-9 days, then disappear. This cycle may continue for several weeks if the person is not treated. Other later symptoms may include nausea, vomiting, anorexia, dry cough, photophobia, rash, neck pain, eye pain, confusion and dizziness.

Physical Examination
Although there can be multiple findings on physical exam there are no classic findings for TBRF. The most evident finding is a moderately ill appearing person who is mildly to moderately dehydrated. Some people develop mild to moderate hepatosplenomegaly, enlarged liver and spleen. Other potential findings on clinical exam include meningismus (stiff neck and headache with photophobia), pleuritic pain and rub (chest pain), photophobia (fear of light).

Skin
Often there is accompanying yellowing of the skin or jaundice. Skin exam can reveal a nonspecific macular rash and/or scattered petechiae.

Eyes
Often there is conjunctivitis (red eyes) and sclarae icteric (yellowing of the white part of the eyes).