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Caves in the region can host soft ticks carrying Borrelia persica, the pathogen responsible for tick-borne relapsing fever and blurred vision.
By Shula Rosen
Doctors at Rambam Health Care Campus say they finally solved a puzzling case involving two 16-year-olds from Western Galilee who arrived with deteriorating vision, recurring fever and no clear explanation.
The teens, Itamar Franco of Nes Ammim and Noam Chen of Nahariya, had taken part in what they thought would be a routine outing weeks earlier, only to suddenly experience high fever and blurred vision.
The boys said they had descended into a local man-made shaft long known among area youths for casual rappelling and short underground crawls. Within days of the excursion, each began feeling sick. Chen told Ynet, “I had a high fever for a few days, then it went away, came back and disappeared again,” describing an on-and-off cycle that continued as his eyesight darkened with shadowy patches.
Their mothers initially treated the fever at home, but both families sought help when the vision problems intensified. Eye specialists found severe inflammation and directed them to Rambam’s emergency department.
Dr. Yael Ben Arie, a senior ophthalmologist at Rambam, said the symptoms were worrying and difficult to explain. “When we first examined Noam, he described pain, redness, light sensitivity and blurred vision,” she said, noting that the pattern did not immediately point to a single diagnosis.
For several days, tests failed to produce answers. Only after the parents mentioned the cave visit did physicians reconsider the case. That detail, Ben Arie said, prompted consultation with an infectious disease expert.
Caves in the region can host soft ticks carrying Borrelia persica, the pathogen responsible for tick-borne relapsing fever.
Dr. Michal Meir of Rambam’s pediatric infectious disease unit said the overlapping timeline of fever followed by eye inflammation fit the suspicion.
A blood smear later revealed the bacterium’s distinctive spiral form in one of the boys. Both began antibiotic and steroid therapy and are now recovering.
The teens say they have warned friends to avoid the site. “I’m done with caves for now,” Franco said. Chen added that he might return “if they clear out those ticks,” but for now the priority is getting well.
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