{"id":"https://openalex.org/W7225310585","doi":"https://doi.org/10.1186/s12348-026-00663-1","title":"Borrelia persica\u2013associated intraocular infection following a relapsing febrile illness: a case report","display_name":"Borrelia persica\u2013associated intraocular infection following a relapsing febrile illness: a case report","publication_year":2026,"publication_date":"2026-11-05","ids":{"openalex":"https://openalex.org/W7225310585","doi":"https://doi.org/10.1186/s12348-026-00663-1"},"language":"en","primary_location":{"id":"doi:10.1186/s12348-026-00663-1","doi":"https://doi.org/10.1186/s12348-026-00663-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12348-026-00663-1","pdf_url":null,"source":{"id":"https://openalex.org/S2738472438","display_name":"Journal of Ophthalmic Inflammation and Infection","issn_l":"1869-5760","issn":["1869-5760"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","doyens","jufo-1","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Ophthalmic Inflammation and Infection","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12348-026-00663-1","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5080732726","display_name":"Tehila Shlomov","orcid":"https://orcid.org/0009-0004-7584-933X","observed_orcids":["https://orcid.org/0009-0004-7584-933X"]},"institutions":[{"id":"https://openalex.org/I197251160","display_name":"Hebrew University of Jerusalem","ror":"https://ror.org/03qxff017","country_code":"IL","type":"education","lineage":["https://openalex.org/I197251160"]},{"id":"https://openalex.org/I2799899409","display_name":"Hadassah Medical Center","ror":"https://ror.org/01cqmqj90","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2799899409"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Tehila Shlomov","raw_affiliation_strings":["Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel","institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5000944128","display_name":"Daniel Grupel","orcid":"https://orcid.org/0000-0002-8315-1204","observed_orcids":["https://orcid.org/0000-0002-8315-1204"]},"institutions":[{"id":"https://openalex.org/I197251160","display_name":"Hebrew University of Jerusalem","ror":"https://ror.org/03qxff017","country_code":"IL","type":"education","lineage":["https://openalex.org/I197251160"]},{"id":"https://openalex.org/I2799899409","display_name":"Hadassah Medical Center","ror":"https://ror.org/01cqmqj90","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2799899409"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Daniel Grupel","raw_affiliation_strings":["Department of Clinical Microbiology and Infectious Diseases, Hadassah\u2013Hebrew University Medical Center, Jerusalem, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Clinical Microbiology and Infectious Diseases, Hadassah\u2013Hebrew University Medical Center, Jerusalem, Israel","institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5022410305","display_name":"Nadav Shemesh","orcid":"https://orcid.org/0000-0002-4614-5673","observed_orcids":["https://orcid.org/0000-0002-4614-5673"]},"institutions":[{"id":"https://openalex.org/I197251160","display_name":"Hebrew University of Jerusalem","ror":"https://ror.org/03qxff017","country_code":"IL","type":"education","lineage":["https://openalex.org/I197251160"]},{"id":"https://openalex.org/I2799899409","display_name":"Hadassah Medical Center","ror":"https://ror.org/01cqmqj90","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2799899409"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Nadav Shemesh","raw_affiliation_strings":["Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel","institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5091530596","display_name":"Itay Nitzan","orcid":"https://orcid.org/0000-0001-6925-5157","observed_orcids":["https://orcid.org/0000-0001-6925-5157"]},"institutions":[{"id":"https://openalex.org/I197251160","display_name":"Hebrew University of Jerusalem","ror":"https://ror.org/03qxff017","country_code":"IL","type":"education","lineage":["https://openalex.org/I197251160"]},{"id":"https://openalex.org/I2799899409","display_name":"Hadassah Medical Center","ror":"https://ror.org/01cqmqj90","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2799899409"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Itay Nitzan","raw_affiliation_strings":["Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel","institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113468171","display_name":"Tareq Jaouni","orcid":"https://orcid.org/0000-0001-5788-5952","observed_orcids":["https://orcid.org/0000-0001-5788-5952"]},"institutions":[{"id":"https://openalex.org/I197251160","display_name":"Hebrew University of Jerusalem","ror":"https://ror.org/03qxff017","country_code":"IL","type":"education","lineage":["https://openalex.org/I197251160"]},{"id":"https://openalex.org/I2799899409","display_name":"Hadassah Medical Center","ror":"https://ror.org/01cqmqj90","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2799899409"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Tareq Jaouni","raw_affiliation_strings":["Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel","institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5019185269","display_name":"Ayelet Michael-Gayego","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I197251160","display_name":"Hebrew University of Jerusalem","ror":"https://ror.org/03qxff017","country_code":"IL","type":"education","lineage":["https://openalex.org/I197251160"]},{"id":"https://openalex.org/I2799899409","display_name":"Hadassah Medical Center","ror":"https://ror.org/01cqmqj90","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2799899409"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Ayelet Michael-Gayego","raw_affiliation_strings":["Department of Clinical Microbiology and Infectious Diseases, Hadassah\u2013Hebrew University Medical Center, Jerusalem, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Clinical Microbiology and Infectious Diseases, Hadassah\u2013Hebrew University Medical Center, Jerusalem, Israel","institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015559121","display_name":"Keren Olstein","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I197251160","display_name":"Hebrew University of Jerusalem","ror":"https://ror.org/03qxff017","country_code":"IL","type":"education","lineage":["https://openalex.org/I197251160"]},{"id":"https://openalex.org/I2799899409","display_name":"Hadassah Medical Center","ror":"https://ror.org/01cqmqj90","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2799899409"]}],"countries":["IL"],"is_corresponding":false,"raw_author_name":"Keren Olstein","raw_affiliation_strings":["Department of Clinical Microbiology and Infectious Diseases, Hadassah\u2013Hebrew University Medical Center, Jerusalem, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Clinical Microbiology and Infectious Diseases, Hadassah\u2013Hebrew University Medical Center, Jerusalem, Israel","institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5072929068","display_name":"Radgonde Amer","orcid":"https://orcid.org/0000-0002-5730-4254","observed_orcids":["https://orcid.org/0000-0002-5730-4254"]},"institutions":[{"id":"https://openalex.org/I197251160","display_name":"Hebrew University of Jerusalem","ror":"https://ror.org/03qxff017","country_code":"IL","type":"education","lineage":["https://openalex.org/I197251160"]},{"id":"https://openalex.org/I2799899409","display_name":"Hadassah Medical Center","ror":"https://ror.org/01cqmqj90","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2799899409"]}],"countries":["IL"],"is_corresponding":true,"raw_author_name":"Radgonde Amer","raw_affiliation_strings":["Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Ophthalmology, Hadassah\u2013Hebrew University Medical Center, Hadassah University Hospital, POB 12000, Jerusalem, 91120, Israel","institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5072929068"],"corresponding_institution_ids":["https://openalex.org/I197251160","https://openalex.org/I2799899409"],"apc_list":{"value":2290,"currency":"USD","value_usd":2290},"apc_paid":{"value":2290,"currency":"USD","value_usd":2290},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10296","display_name":"Vector-borne infectious diseases","score":0.8471999764442444,"subfield":{"id":"https://openalex.org/subfields/2405","display_name":"Parasitology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T10296","display_name":"Vector-borne infectious diseases","score":0.8471999764442444,"subfield":{"id":"https://openalex.org/subfields/2405","display_name":"Parasitology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T11826","display_name":"Ocular Infections and Treatments","score":0.10029999911785126,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11194","display_name":"Ocular Diseases and Beh\u00e7et\u2019s Syndrome","score":0.020800000056624413,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/borrelia-persica","display_name":"Borrelia persica","score":1.0},{"id":"https://openalex.org/keywords/tick-borne-relapsing-fever","display_name":"tick-borne relapsing fever","score":0.8629999756813049},{"id":"https://openalex.org/keywords/intraocular-infection","display_name":"intraocular infection","score":0.9049999713897705},{"id":"https://openalex.org/keywords/panuveitis","display_name":"panuveitis","score":0.9129999876022339},{"id":"https://openalex.org/keywords/vitreitis","display_name":"vitritis","score":0.847000002861023},{"id":"https://openalex.org/keywords/vitreous-fluid","display_name":"vitreous fluid","score":0.5740000009536743},{"id":"https://openalex.org/keywords/16s-rrna-gene-pcr","display_name":"16S rRNA PCR","score":0.7749999761581421},{"id":"https://openalex.org/keywords/doxycycline","display_name":"doxycycline","score":0.9490000009536743},{"id":"https://openalex.org/keywords/vitrectomy","display_name":"vitrectomy","score":0.7919999957084656},{"id":"https://openalex.org/keywords/optic-disc-edema","display_name":"optic disc edema","score":0.7379999756813049},{"id":"https://openalex.org/keywords/retinal-periphlebitis","display_name":"retinal periphlebitis","score":0.9829999804496765}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9032999873161316},{"id":"https://openalex.org/C2777179404","wikidata":"https://www.wikidata.org/wiki/Q422442","display_name":"Doxycycline","level":3,"score":0.6092000007629395},{"id":"https://openalex.org/C2776194053","wikidata":"https://www.wikidata.org/wiki/Q280027","display_name":"Uveitis","level":2,"score":0.6055999994277954},{"id":"https://openalex.org/C2778257484","wikidata":"https://www.wikidata.org/wiki/Q555066","display_name":"Visual acuity","level":2,"score":0.5351999998092651},{"id":"https://openalex.org/C118487528","wikidata":"https://www.wikidata.org/wiki/Q161437","display_name":"Ophthalmology","level":1,"score":0.5250999927520752},{"id":"https://openalex.org/C16005928","wikidata":"https://www.wikidata.org/wiki/Q171171","display_name":"Dermatology","level":1,"score":0.4072999954223633},{"id":"https://openalex.org/C2779368723","wikidata":"https://www.wikidata.org/wiki/Q8511208","display_name":"Intermediate uveitis","level":4,"score":0.37369999289512634},{"id":"https://openalex.org/C206179267","wikidata":"https://www.wikidata.org/wiki/Q188952","display_name":"Medical history","level":2,"score":0.36070001125335693},{"id":"https://openalex.org/C49105822","wikidata":"https://www.wikidata.org/wiki/Q176996","display_name":"Polymerase chain reaction","level":3,"score":0.3537999987602234},{"id":"https://openalex.org/C2776804153","wikidata":"https://www.wikidata.org/wiki/Q210420","display_name":"Corticosteroid","level":2,"score":0.3239000141620636},{"id":"https://openalex.org/C2777168383","wikidata":"https://www.wikidata.org/wiki/Q4677951","display_name":"Acute retinal necrosis","level":5,"score":0.299699991941452},{"id":"https://openalex.org/C2780997015","wikidata":"https://www.wikidata.org/wiki/Q2610154","display_name":"Red eye","level":2,"score":0.29030001163482666},{"id":"https://openalex.org/C527108885","wikidata":"https://www.wikidata.org/wiki/Q835153","display_name":"Physical examination","level":2,"score":0.2833999991416931},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.27630001306533813},{"id":"https://openalex.org/C2777235844","wikidata":"https://www.wikidata.org/wiki/Q1294912","display_name":"Endophthalmitis","level":2,"score":0.2596000134944916},{"id":"https://openalex.org/C2779215961","wikidata":"https://www.wikidata.org/wiki/Q310904","display_name":"Mycoplasma pneumoniae","level":3,"score":0.25609999895095825},{"id":"https://openalex.org/C2776148792","wikidata":"https://www.wikidata.org/wiki/Q3041498","display_name":"Eye disease","level":2,"score":0.2558000087738037},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.25380000472068787},{"id":"https://openalex.org/C2781092963","wikidata":"https://www.wikidata.org/wiki/Q650050","display_name":"Intraocular pressure","level":2,"score":0.25209999084472656}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12348-026-00663-1","doi":"https://doi.org/10.1186/s12348-026-00663-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12348-026-00663-1","pdf_url":null,"source":{"id":"https://openalex.org/S2738472438","display_name":"Journal of Ophthalmic Inflammation and Infection","issn_l":"1869-5760","issn":["1869-5760"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","doyens","jufo-1","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Ophthalmic Inflammation and Infection","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12348-026-00663-1","doi":"https://doi.org/10.1186/s12348-026-00663-1","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12348-026-00663-1","pdf_url":null,"source":{"id":"https://openalex.org/S2738472438","display_name":"Journal of Ophthalmic Inflammation and Infection","issn_l":"1869-5760","issn":["1869-5760"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","doyens","jufo-1","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Ophthalmic Inflammation and Infection","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2036918286","https://openalex.org/W2285516930","https://openalex.org/W4387046024","https://openalex.org/W2281661802","https://openalex.org/W1974739813","https://openalex.org/W4393117977","https://openalex.org/W944378501","https://openalex.org/W2156078072","https://openalex.org/W4229448830","https://openalex.org/W2885196358"],"abstract_inverted_index":{"Abstract":[0],"Purpose":[1],"To":[2,166],"describe":[3],"the":[4,32,171,203,212],"clinical":[5],"course":[6],"of":[7,55,67,122,163,174,178,185,205,238,249],"a":[8,16,52,65,144,223,229],"patient":[9,230],"who":[10],"presented":[11,50],"with":[12,51,85,132,157,231],"unilateral":[13],"panuveitis":[14,84,233],"following":[15],"relapsing":[17,225,240],"febrile":[18,69,226],"illness":[19,227],"and":[20,37,61,91,96,143,151,208,242],"in":[21,28,181,189,228],"whom":[22],"B.":[23,126,179,186,193],"persica":[24,127,180,187,194],"DNA":[25,188],"was":[26,78,99],"detected":[27],"vitreous":[29,124,190],"fluid,":[30],"emphasizing":[31],"diagnostic":[33,110],"challenges,":[34],"microbiologic":[35],"findings,":[36],"therapeutic":[38],"outcome.":[39],"Methods":[40],"Observational":[41],"case":[42],"report.":[43],"Results":[44],"A":[45],"previously":[46],"healthy":[47],"20-year-old":[48],"man":[49],"one-week":[53],"history":[54],"right":[56],"eye":[57,213],"floaters,":[58],"redness,":[59],"pain,":[60],"photophobia,":[62],"preceded":[63],"by":[64],"month":[66],"recurrent":[68],"episodes":[70],"initially":[71],"attributed":[72],"to":[73,155,211],"gastroenteritis.":[74],"Best-corrected":[75],"visual":[76,152],"acuity":[77,153],"hand":[79],"motion.":[80],"He":[81],"had":[82],"non-granulomatous":[83],"dense":[86],"vitritis,":[87],"optic":[88],"disc":[89],"edema,":[90],"retinal":[92],"periphlebitis.":[93],"Systemic":[94],"infectious":[95],"autoimmune":[97],"evaluation":[98],"unremarkable.":[100],"Despite":[101],"high-dose":[102],"systemic":[103,250],"corticosteroid":[104,146],"therapy,":[105],"vitritis":[106],"remained":[107],"marked,":[108],"prompting":[109],"vitrectomy.":[111],"Broad-range":[112],"bacterial":[113],"16":[114],"S":[115],"rRNA":[116],"gene":[117],"polymerase":[118],"chain":[119],"reaction":[120],"(PCR)":[121],"undiluted":[123],"identified":[125],".":[128],"Following":[129],"combined":[130],"management":[131],"vitrectomy,":[133],"oral":[134],"doxycycline":[135],"100":[136],"mg":[137],"twice":[138],"daily":[139],"for":[140],"14":[141],"days,":[142],"gradual":[145],"taper,":[147],"intraocular":[148,182,196,243],"inflammation":[149],"resolved":[150],"recovered":[154],"20/25,":[156],"no":[158],"recurrence":[159],"during":[160],"three":[161],"months":[162],"follow-up.":[164],"Conclusions":[165],"our":[167],"knowledge,":[168],"this":[169],"is":[170],"first":[172],"report":[173],"species-level":[175],"molecular":[176],"detection":[177],"fluid.":[183],"Detection":[184],"fluid":[191,244],"supports":[192],"\u2013associated":[195],"infection,":[197],"although":[198],"PCR":[199],"does":[200],"not":[201],"establish":[202],"presence":[204],"viable":[206],"organisms,":[207],"hematogenous":[209],"dissemination":[210],"can":[214],"be":[215],"neither":[216],"confirmed":[217],"nor":[218],"excluded.":[219],"In":[220],"endemic":[221],"regions,":[222],"recent":[224],"severe":[232],"should":[234],"prompt":[235],"early":[236],"consideration":[237],"tick-borne":[239],"fever":[241],"sampling,":[245],"preferably":[246],"before":[247],"escalation":[248],"immunosuppression.":[251]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-11-06T00:00:00"}