Journal of Clinical Case Reports

A 13-Year Old Female with Pancytopenia at the Presentation of a Borrelia Hispanica Infection: Case Report and Review of the Literature

Abstract

Irmin Leen, Peggy Bruynseels, Mark van Oort and Machiel van den Akker

Background: It is not uncommon that a child with a febrile illness of unknown etiology is admitted to the hospital. When the complete blood count reveals a pancytopenia, the diagnostic process can be a real challenge.

Case presentation: A 13-year female of Arab-Berber descent presented with abdominal pain and fever after a vacation in north-western Morocco. Complete blood count revealed a pancytopenia and blood smear revealed spirochetes. Borrelia hispanica was identified by sequencing the 16S rRNA gene. The patient was treated with tetracyclines and during this treatment we saw full clinical and hematological recovery.

Conclusions: Borrelia hispanica is a known cause of Tick-borne relapsing fever and is transmitted to humans through the bite of soft ticks of the genus Ornithodoros (Alectorobius). Although the link between tick-borne relapsing fever (TBRF) and thrombocytopenia has been documented, there are only a few case reports of TBRF presenting with pancytopenia. To the best of our knowledge, there is no previously report of Borrelia hispanica presenting with pancytopenia.

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