II. Epidemiology
- Affected 1 million during World War I (1914 to 1918)
III. Pathophysiology
- Bartonella Quintana
- Small Gram Negative Rod
- Previously known as Quintana or Rochalimaea Quintana
- However, reclassified as it is not an obligate intracellular Parasite (unlike Rickettsia)
- Species name "Quintana" is derived from the fever that recurrs every 5 days
- Transmission
- Louse-Borne Illness (Body Lice)
IV. Risk Factors
-
Homelessness
- Under-recognized infections, with delayed diagnosis and treatment
- Alcoholism
- Crowded living conditions with poor sanitation practices
- Outbreaks have occurred in War (hence the name "Trench Fever")
V. Findings
-
Relapsing Fever (every 5 days)
- May present as Fever of Unknown Origin
- Headaches
- Myalgias
- Back and Leg Pain
- Splenomegaly
- Rash (variable)
VI. Labs
- Blood Cultures
- Bartonella Quintana PCR
- Indirect Immunofluorescence Assay (IFA) for Bartonella Quintana
- Cross reactivity with Bartonella Henselae
VII. Differential Diagnosis
-
Epidemic Typhus (Rickettsia prowazekii)
- Also spread via Body Lice in crowded, low sanitation conditions
VIII. Management
- Two Drug Antibiotic Regimen
- Doxycycline 100 mg orally twice daily AND
- Gentamicin 3 mg/kg IV daily for first 2 weeks
- Alternative: Rifampin 300 mg orally twice daily for first 2 weeks
IX. Complications
- Bacteremia
-
Bacterial Endocarditis
- Primary cause of mortality in Bartonella Quintana
-
Bacillary Angiomatosis
- AIDS (CD4 Count <100 cells/mm3)
- Other Immunocompromised patients
X. References
- (2023) Sanford Guide, accessed on IOS 2/14/2025
- Angelakis (2014) Int J Antimicrob Agents 44(1):16-25 +PMID: 24933445 [PubMed]
- Boodman (2024) Pathogens 13(12):1071 +PMID: 39770331 [PubMed]
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Related Studies
| Definition (NCI) | A species of Gram-negative, rod shaped bacteria assigned to the phylum Proteobacteria. This species is nonmotile, oxidase positive, indole and urease negative, and nonhemolytic. B. quintana causes trench fever. |
| Definition (NCI_CDISC) | Any bacterial organism that can be assigned to the species Bartonella quintana. |
| Definition (MSH) | A species of gram-negative bacteria in which man is the primary host and the human body louse, Pediculus humanus, the principal vector. It is the etiological agent of TRENCH FEVER. |
| Concepts | Bacterium (T007) |
| MSH | D018413 |
| SnomedCT | 112355007, 103511001 |
| LNC | LP14387-2 |
| English | Rochalimaea quintana, Rickettsia quintana, Bartonella quintana, Bartonella quintana (bacteria), Burnetia (Rocha-limae) wolhynica, Rochalimaea quintana (Schmincke 1917) Krieg 1961 (Approved Lists 1980), Bartonella quintana (Schmincke 1917) Brenner et al. 1993, Rickettsia pediculi, Rickettsia weigli, Rickettsia wolhynica, Wolhynia qintanae, Rochalimea quintana (organism), ROCHALIMAEA QUINTANA, BARTONELLA QUINTANA, Bartonella quintana (organism), Rochalimea quintana -RETIRED- |
| French | Rochalimaea quintana, Bartonella quintana, Rickettsia quintana |
| Swedish | Bartonella quintana |
| Czech | Bartonella quintana, Rochalimaea quintana, Rickettsia quintana |
| Finnish | Bartonella quintana |
| Italian | Rochalimaea quintana, Rickettsia quintana, Bartonella quintana |
| Japanese | 五日熱リケッチア, ロシャリメア･クインターナ, ウォリニー熱リケッチア, 塹壕熱リケッチア, 塹壕熱ロカメリア, ざんごう熱リケッチア |
| Polish | Rickettsia quintana, Rochalimaea quintana, Bartonella quintana |
| Spanish | Rochalimaea quintana - RETIRADO -, Rochalimaea quintana - RETIRADO - (concepto no activo), Bartonella quintana (organismo), Bartonella quintana, Rickettsia quintana, Rochalimaea quintana |
| Norwegian | Bartonella quintana, Rochalimaea quintana, Rickettsia quintana |
| German | Bartonella quintana, Rickettsia quintana, Rochalimaea quintana |
| Russian | BARTONELLA QUINTANA, RICKETTSIA QUINTANA, ROCHALIMAEA QUINTANA |
| Dutch | Bartonella quintana, Rochalimaea quintana |
| Portuguese | Bartonella quintana, Rickettsia quintana, Rochalimaea quintana |
Ontology: Trench Fever (C0040830)
| Definition (MSH) | An intermittent fever characterized by intervals of chills, fever, and splenomegaly each of which may last as long as 40 hours. It is caused by BARTONELLA QUINTANA and transmitted by the human louse. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D014205 |
| ICD9 | 083.1 |
| ICD10 | A79.0 |
| SnomedCT | 82214002 |
| English | Fevers, Trench, Trench Fever, Trench Fevers, Fever, Trench, trench fever, five day fever, trench fever (diagnosis), trench fever (rickettsia quintana), fever due to Bartonella quintana, Rochalimaea quintana infection, Trench Fever [Disease/Finding], Quintan fever, Trench fever, Fever due to Rochalimaea quintana, Wolhynian fever, Febris quintata, Five day fever, Fever due to Bartonella quintana, Trench fever (disorder), His-Werner, febris; quintana, fever; quintan, fever; trench fever, fever; trench, fever; wolhynian, quintan; fever, quintana; febris, trench fever; fever, trench; fever, wolhynian fever, wolhynian; fever |
| Dutch | Rochalimaea quintana-infectie, Wolhynia; koorts, febris; quintana, fever; trench, koorts; Wolhynia, koorts; loopgravenkoorts, koorts; vijfdedaagse, loopgravenkoorts; koorts, quintana; febris, trench; fever, vijfdedaagse; koorts, loopgravenkoorts, Koorts, loopgraven-, Loopgravenkoorts |
| French | Infection à Rochalimaea quintana, Fièvre aigüe tibialgique, Fièvre aiguë tibialgique, Fièvre quintane, Fièvre des tranchées, Fièvre de Volhynie, Fièvre de Volkynee, Fièvre de la Meuse, Fièvre des cinq jours, Fièvre quinte |
| German | Rochalimaea quintana-Infektion, Schuetzengrabenfieber, Febris quintana, Wolhynisches Fieber, Fünftagefieber |
| Italian | Infezione da Rochalimaea quintana, Febbre delle trincee |
| Portuguese | Infecção quintana por Rochalimaea, Febre das trincheiras, Febre das Trincheiras |
| Spanish | Infección por Rochalimaea quintana, fiebre de las trincheras (trastorno), fiebre de las trincheras, fiebre de los cinco días, fiebre por Bartonella quintana, fiebre por Rochalimaea quintana, fiebre quintana, Fiebre de las trincheras, Fiebre de las Trincheras |
| Japanese | ざんごう熱, ロシャリメア・クインターナ感染症, ｻﾞﾝｺﾞｳﾈﾂ, ﾛｼｬﾘﾒｱｸｲﾝﾀｰﾅｶﾝｾﾝｼｮｳ |
| Swedish | Skyttegravsfeber |
| Czech | zákopová horečka, volyňská horečka, Infekce způsobená Rochalimaea quintana, Zákopová horečka |
| Finnish | Ampumahautakuume |
| Russian | OKOPNAIA LIKHORADKA, LIKHORADKA OKOPNAIA, ЛИХОРАДКА ОКОПНАЯ, ОКОПНАЯ ЛИХОРАДКА |
| Korean | 참호열 |
| Polish | Gorączka okopowa, Gorączka wołyńska, Gorączka pięciodniowa, Gorączka mozelska |
| Hungarian | Rochalimaea quintana fertőzés, lövészárok láz |
| Norwegian | Febris quintana, Skyttergravsfeber |
