{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:22:56Z","timestamp":1791285776515,"version":"4.1.0"},"reference-count":13,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,8,23]],"date-time":"2013-08-23T00:00:00Z","timestamp":1377216000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:p>Relapsing fever is a disease caused by one of the species of Borrelia. It is often misdiagnosed as malaria and can have fatal complications such as the Jarisch-Herxheimer reaction (JHR) after the commencement of treatment with antibiotics. A 19-year-old Tanzanian woman was admitted after a term home delivery that day. She presented with a 2 day history of fever, headache, general body malaise and vomiting. She was misdiagnosed as having severe malaria and was treated with quinine. The blood slide showed Borrelia duttoni. The patient continued treatment with procaine penicillin fortified for relapsing fever. Several hours later the woman died, probably due to JHR. This case of a patient with relapsing fever who died from a JHR stresses the importance of adequate diagnosis and treatment which should include careful monitoring, especially for the first hours after starting antibiotics.<\/jats:p>","DOI":"10.1177\/0049475513497477","type":"journal-article","created":{"date-parts":[[2013,8,24]],"date-time":"2013-08-24T00:59:19Z","timestamp":1377305959000},"page":"138-141","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Maternal mortality in a rural Tanzanian hospital: fatal Jarisch-Herxheimer reaction in a case of relapsing fever in pregnancy"],"prefix":"10.1177","volume":"43","author":[{"given":"Ilona","family":"Rustenhoven-Spaan","sequence":"first","affiliation":[{"name":"Medical Doctor, Dept of Obstetrics and Gynaecology, Haydom Lutheran Hospital, Tanzania"},{"name":"Medical Doctor, Dept of Anesthesiology, Academic Medical Centre, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Melkert","sequence":"additional","affiliation":[{"name":"Pathologist, PHC Laboratory, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Nelissen","sequence":"additional","affiliation":[{"name":"Medical Doctor, Dept of Obstetrics and Gynaecology, Haydom Lutheran Hospital, Tanzania"},{"name":"Medical Doctor, Faculty of Earth and Life Sciences, VU University, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos","family":"van Roosmalen","sequence":"additional","affiliation":[{"name":"Gynaecologist, Dept of Obstetrics, Leiden University Medical Centre, The Netherlands"},{"name":"Gynaecologist, EMGO Institute, VU University Medical Centre, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle","family":"Stekelenburg","sequence":"additional","affiliation":[{"name":"Gynaecologist, Department of Obstetrics and Gynaecology, Leeuwarden Medical Centre, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,8,23]]},"reference":[{"key":"bibr1-0049475513497477","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14609-0"},{"key":"bibr2-0049475513497477","doi-asserted-by":"publisher","DOI":"10.3109\/00016349709024361"},{"key":"bibr3-0049475513497477","first-page":"875","volume":"68","author":"Melkert PW","year":"1991","journal-title":"East Afr Med J"},{"key":"bibr4-0049475513497477","first-page":"1","volume":"4","author":"McCall PJ","year":"2007","journal-title":"Vector Borne Zoonotic Dis"},{"key":"bibr5-0049475513497477","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(90)90106-O"},{"key":"bibr6-0049475513497477","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.73.11.7669-7676.2005"},{"key":"bibr7-0049475513497477","doi-asserted-by":"publisher","DOI":"10.1086\/516273"},{"key":"bibr8-0049475513497477","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2011.04.004"},{"key":"bibr9-0049475513497477","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68968-X"},{"key":"bibr10-0049475513497477","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1988.tb06516.x"},{"key":"bibr11-0049475513497477","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e32832fb22b"},{"key":"bibr12-0049475513497477","first-page":"92","volume":"39","author":"Melkert PW","year":"1987","journal-title":"Trop Geogr Med"},{"key":"bibr13-0049475513497477","first-page":"284","volume":"64","author":"Melkert PW","year":"1987","journal-title":"East Afr Med J"}],"container-title":["Tropical Doctor"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0049475513497477","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0049475513497477","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0049475513497477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:28:37Z","timestamp":1777642117000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0049475513497477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8,23]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1177\/0049475513497477"],"URL":"https:\/\/doi.org\/10.1177\/0049475513497477","relation":{},"ISSN":["0049-4755","1758-1133"],"issn-type":[{"value":"0049-4755","type":"print"},{"value":"1758-1133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8,23]]}}}