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Updated: May 5, 2026

Feeding of Ticks on Animals for Transmission and Xenodiagnosis in Lyme Disease Research
Published on: August 31, 2013
A Case of Travel-Associated Tick-Borne Relapsing Fever in Wisconsin
Michael E Rockman1, Zaynab Almothafer2, Rylee Doucette2
1Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, mrockman@wisc.edu.
Introduction:
Tick-borne relapsing fever is a zoonotic infection caused by members of the Borrelia genus of spirochetes found predominantly in the southwestern United States.
Case Presentation:
A 65-year-old woman presented to a Wisconsin emergency department with a 2-day history of fevers and altered mental status after returning from a 5-week stay in Colorado. Initial labs were notable for elevated transaminases, thrombocytopenia, mild hyponatremia, mild hypokalemia, and elevated procalcitonin.
Discussion:
Rapid identification of patients with tick-borne relapsing fever is essential to minimize morbidity and mortality. Peripheral blood smear - especially during a febrile episode - can serve as a quick and accurate way to diagnose the illness with direct visualization of spirochetes.
Conclusions:
Early analysis of a peripheral blood smear can lead to a swift diagnosis of tick-borne relapsing fever, particularly in nonendemic states such as Wisconsin.
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