Tick-borne relapsing fever is a bacterial infection that can cause fever that comes and goes, headache, muscle pain, joint aches, and nausea. The fever pattern is often characterized by three days with high fever followed by seven days without fever and another three days with a fever. If left untreated, this cycle continues. TBRF is usually carried by soft ticks who nest near rodent dens and come out at night to feed on the host, similar to bed bugs. Exposure often occurs in remote cabins in the western United States, where the ticks live in the walls or attic. Another form of TBRF, Borrelia miyamotoi disease, is known as “hard tick relapsing fever,” as the black-legged tick, which has a hard body, transmits B. miyamotoi.