Abstract
26 patients with louse-borne relapsing fever (L.B.R.F.) and 10 others with serologically proven epidemic typhus were treated with a single oral dose of 100 mg. of doxycycline. All patients were cured and no relapses of L.B.R.F. or typhus occurred during the 2-week period of posttreatment observation. Each of the L.B.R.F. patients experienced a Jarisch-Herxheimer reaction following treatment, which was complicated by hypotension and/or cardiac failure in 5 patients. This was successfully treated with intravenous digoxin. The difficulty of diagnosing typhus and differentiating it from enteric fevers may restrict the use of single-dose doxycycline to epidemics or to mass-treatment campaigns directed at eradicating the human reservoirs of these infections.
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