A rare case: a 15-year-old was diagnosed with "cave fever" at the Bnei Zion Medical Center in Haifa

A 15-year-old boy from a settlement in the north came to the children's emergency room at the Bnei Zion Medical Center suffering from a high fever, headache, rash and vomiting, which started four days before his visit.

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In the emergency room, treatment was immediately started with the administration of fluids and broad-spectrum intravenous antibiotics – and a few minutes after the administration of the antibiotics, the boy had a severe reaction manifested by body tremors, changes in blood pressure, rapid pulse, increased vomiting and marked restlessness.

Dr. Mordechai Pollak, who was the initiator, suspected cave fever and a quick blood test identified the Borrelia bacterium under the microscope by the microbiological laboratory team.

Dr. Yoel Bar Shalom, from the children's emergency department at the Bnei Zion Medical Center, notes that "following the finding, the boy was questioned again and he said that indeed, a week before his application, he stayed for about an hour in an isolated cave in the Lower Galilee, and there he was most likely stung by the well-known soft ticks as carriers of the disease."

The boy was hospitalized for several days in the children's ward, treated with antibiotics according to the cause, and under the treatment his condition stabilized and he was released to his home.

The Director of Children's Emergency at the Bnei Zion Medical Center, Dr. Irena Chistyakov, explains: "Such a systemic reaction to the administration of a certain type of antibiotic raises the suspicion that this is a situation in which there is a spirochete bacteria in the blood (Borrelia in this case) that is transmitted to a person through the bite of the 'cave tick' and causes to a fever called "cave fever".

The director of the infectious diseases unit at Bnei Zion Medical Center, Dr. Mirit Hershman-Sarapov, adds and describes: "It is important to know that the disease is transmitted to a person through a short bloodsucking, and most of the bitten will not find ticks on their body, but only a sign of the bloodsucking. The fever usually breaks out after an incubation of about five days and is characterized by bouts of fever, shortness of breath, nausea, muscle aches, headaches, and a rash. In Israel every year, a number of individual cases are reported to the Ministry of Health, and there is probably an underdiagnosis. Most of the diagnosed cases are due to prolonged stay/sitting/sleeping prohibited in caves, but also in alcoves, abandoned bunkers, and therefore the public must avoid uncontrolled entry and without adequate preventive measures into caves whose contamination status is unknown. Public awareness of this danger is extremely important."