Tumour necrosis factor, interleukin-6 and C-reactive protein in patients with louse-borne relapsing fever in Ethiopia

The serum concentrations of tumour necrosis factor (TNF), interleukin-6 (IL-6) and C-reactive protein (CRP) were studied in 25 patients with louse-borne relapsing fever, to evaluate their association with the level of bacteraemia, anti-borrelia chemotherapy and the presence of a Jarish-Herxheimer reaction (JHR). Although there was an association between the level of bacteraemia and the development of JHR and complications during treatment, TNF, IL-6 and CRP concentrations were not associated with the JHR. TNF concentrations increased after the administration of antibiotics and remained high for 24 h. IL-6 was elevated on admission but soon decreased. CRP was high on admission and remained so throughout the illness. The observed elevations in TNF, IL-6 and CRP may be associated more with the administration of antibiotics than with the presence of a JHR.