Neonatal Borrelia species infection (relapsing fever)

P. Yagupsky and S. Moses

Two cases of neonatal Borrelia infection occurred. The first was in a 30-hour-old Bedouin neonate who had been delivered of a febrile mother in a tent. She was admitted to the hospital on the second day of life in a good, general state. Her condition deteriorated a few hours after admission when jaundice, hepatosplenomegaly, and hemorrhage appeared. Borrelia organisms were found on peripheral blood smear. The patient died 16 hours after admission. Findings from the physical examination of the mother were normal, and no Borrelia organisms were seen in her blood smears. The second case was in a 15-day-old male newborn who was admitted to the hospital with severe jaundice, hepatosplenomegaly, bleeding tendency, and evidence of severe acidosis. Multiple spirochetes were found in blood and CSF smears. His clinical course was fulminant, and despite massive antibiotic treatment, he died within 24 hours of admission. Three weeks prior to delivery, the mother had had a febrile illness. Examination of the mother and her blood at the time of the illness of her son did not disclose any abnormalities.