ABSTRACT
Relapsing fever is a spirochetal disease that is caused by different Borrelia species. Relapsing fever is well recognized as an infection of the blood, characterized with episodes of fever, rigor and spirochetemia; but little is known about its predilection for nervous system. This report is supposed to present a patient with neuroborreliosis during relapsing fever. The presented patient in this paper is a 22 year old woman from Afghanistan with clinical features of meningitis and recurrent episodes of fever with rigor. In diagnostic evaluation, the patient had a CSF profile with aseptic meningitis pattern, and in third time peripheral blood smear spirochet was reported. With diagnosis of meningitis during relapsing fever, she was treated by intravenous ceftriaxone. With administration of first dose of ceftriaxone, Jarisch - Herxheimer reaction occurred. Patient was treated for 14 days by intravenous ceftriaxone. At the end of treatment, the patient was symptom free and had a normal CSF profile. Therefore patient was discharged. In the patients with aseptic meningitis in endemic regions, besides common agents, relapsing fever should also be considered
ABSTRACT
The most serious result of inappropriate usage of antibiotics is increased prevalence and emergence ofmultidrug resistant organisms. We studied antibiotic prescribing for hospitalized patients in Infectious diseases, Medical emergency, Pediatric emergency and General Surgery wards of Imam Reza hospital for 4 months. We completed 535 questionnaire forms and evaluated them. Inappropriate usage of antibiotics was 100%, 66.2%, 84.96%, 50.77% in general surgery, infectious diseases. Medical emergency and pediatric emergency wards, respectively. The most common error in antibiotic prescribing in surgery ward was related to the time of prophylactic antibiotic use preoperatively. However, the most common error in antibiotic usage in medical wards except pediatric emergency ward was improper dosage of antibiotics, and in pediatric emergency ward was inappropriate choosing of antibiotics. In our study, inappropriate use of antibiotics was in unacceptably high and much higher than most other countries