This disease typically involves acute febrile periods followed by remission. This happens in patients because these species of Borrelia can undergo DNA rearrangement and systematically change their surface antigens. Therefore, antibodies made to the previous antigens are no longer effective. The organism and fevers may recur, causing relapsing episodes.
The fever typically lasts 3 to 4 days. Then, there is an interval without fever averaging seven days. Episodes of fever are less severe with each recurring episode. Relapses can occur one to four times. Patients also report headaches with body, muscle, and joint pains. Nausea, vomiting, and anorexia can also be found, along with a dry cough, sensitivity to light, neck pain, eye pain, confusion, and dizziness.
General laboratory values include:
- Mild leukocytosis
- Elevated erythrocyte sedimentation rate (ESR)
- Loss of appetite
- Thrombocytopenia (e.g., ≤50,000 platelets per mm3)
- Increased serum unconjugated bilirubin levels
- Increased aminotransferase levels
- Prolonged prothrombin time (PT) and partial thromboplastin time (PTT)
- Proteinuria and microhematuria
