Community hub
Recent from talks
Knowledge base stats:
Talk channels stats:
Members stats:
Trench fever
Trench fever (also known as "five-day fever", "quintan fever" (Latin: febris quintana), and "urban trench fever") is a moderately serious infectious disease caused by the bacterium Bartonella quintana and transmitted by body lice. From 1915 to 1918 between one-fifth and one-third of all British troops reported ill had trench fever while about one-fifth of ill German and Austrian troops had the disease. The disease persists among the homeless. Outbreaks have been documented, for example, in Seattle and Baltimore in the United States among injecting drug users and in Marseille, France, and Burundi.
Trench fever is also called Wolhynia fever, shin bone fever, Meuse fever, His disease, and His–Werner disease or Werner-His disease (after Wilhelm His Jr. and Heinrich Werner).
The disease is classically a five-day fever of the relapsing type, rarely exhibiting a continuous course. The incubation period is relatively long, at about two weeks. The onset of symptoms is usually sudden, with high fever, severe headache, pain on moving the eyeballs, soreness of the muscles of the legs and back, and frequent hyperaesthesia of the shins. The initial fever is usually followed in a few days by a single, short rise, but there may be many relapses between periods without fever. The most constant symptom is pain in the legs. Trench fever episodes may involve loss of appetite, shin pain or tenderness, and spleen enlargement. Generally, one to five periodic episodes of fever occur, separated by four-to six-day-long asymptomatic periods. Recovery takes a month or more. Lethal cases are rare, but in a few cases, "the persistent fever might lead to heart failure". Aftereffects may include neurasthenia, cardiac disturbances, and myalgia.
The disease is caused by the bacterium Bartonella quintana (older names: Rochalimea quintana, Rickettsia quintana), found in the stomach walls of the body louse. Bartonella quintana is closely related to Bartonella henselae, the agent of cat scratch fever and bacillary angiomatosis.
Bartonella quintana is transmitted by contamination of a skin abrasion or louse-bite wound with the faeces of an infected body louse (Pediculus humanus corporis). There have also been reports of an infected louse bite passing on the infection. B. quintana infection has also been noted in transplant recipients from infected donors.
Bartonella quintana diagnosis based on clinical recognition is typically obtained using microbiologic cultures, polymerase chain reaction (PCR) identification, and serological tests.
It is difficult to culture B. quintana because it is a slow-growing, fastidious bacterium with complex nutritional needs and slow growth rates, often requiring specialized culture conditions. In cases with a high likelihood of disease, cultures may be obtained using Ethylenediaminetetraacetic acid (EDTA) bottles or Chocolate agar under 5% CO2 incubated at 35 °C and held for at least 21 days.
Due to its slow growth rate, other molecular diagnosis methods can be utilized, such as polymerase chain reaction (PCR), to detect B. quintana DNA in samples of blood or tissue. According to Zeaiter et. al., “species-specific reverse-transcriptase polymerase chain reaction (RT PCR) was compared to serology” and helped diagnose all three Bartonella species (Okorji O et al., 2025).
Hub AI
Trench fever AI simulator
(@Trench fever_simulator)
Trench fever
Trench fever (also known as "five-day fever", "quintan fever" (Latin: febris quintana), and "urban trench fever") is a moderately serious infectious disease caused by the bacterium Bartonella quintana and transmitted by body lice. From 1915 to 1918 between one-fifth and one-third of all British troops reported ill had trench fever while about one-fifth of ill German and Austrian troops had the disease. The disease persists among the homeless. Outbreaks have been documented, for example, in Seattle and Baltimore in the United States among injecting drug users and in Marseille, France, and Burundi.
Trench fever is also called Wolhynia fever, shin bone fever, Meuse fever, His disease, and His–Werner disease or Werner-His disease (after Wilhelm His Jr. and Heinrich Werner).
The disease is classically a five-day fever of the relapsing type, rarely exhibiting a continuous course. The incubation period is relatively long, at about two weeks. The onset of symptoms is usually sudden, with high fever, severe headache, pain on moving the eyeballs, soreness of the muscles of the legs and back, and frequent hyperaesthesia of the shins. The initial fever is usually followed in a few days by a single, short rise, but there may be many relapses between periods without fever. The most constant symptom is pain in the legs. Trench fever episodes may involve loss of appetite, shin pain or tenderness, and spleen enlargement. Generally, one to five periodic episodes of fever occur, separated by four-to six-day-long asymptomatic periods. Recovery takes a month or more. Lethal cases are rare, but in a few cases, "the persistent fever might lead to heart failure". Aftereffects may include neurasthenia, cardiac disturbances, and myalgia.
The disease is caused by the bacterium Bartonella quintana (older names: Rochalimea quintana, Rickettsia quintana), found in the stomach walls of the body louse. Bartonella quintana is closely related to Bartonella henselae, the agent of cat scratch fever and bacillary angiomatosis.
Bartonella quintana is transmitted by contamination of a skin abrasion or louse-bite wound with the faeces of an infected body louse (Pediculus humanus corporis). There have also been reports of an infected louse bite passing on the infection. B. quintana infection has also been noted in transplant recipients from infected donors.
Bartonella quintana diagnosis based on clinical recognition is typically obtained using microbiologic cultures, polymerase chain reaction (PCR) identification, and serological tests.
It is difficult to culture B. quintana because it is a slow-growing, fastidious bacterium with complex nutritional needs and slow growth rates, often requiring specialized culture conditions. In cases with a high likelihood of disease, cultures may be obtained using Ethylenediaminetetraacetic acid (EDTA) bottles or Chocolate agar under 5% CO2 incubated at 35 °C and held for at least 21 days.
Due to its slow growth rate, other molecular diagnosis methods can be utilized, such as polymerase chain reaction (PCR), to detect B. quintana DNA in samples of blood or tissue. According to Zeaiter et. al., “species-specific reverse-transcriptase polymerase chain reaction (RT PCR) was compared to serology” and helped diagnose all three Bartonella species (Okorji O et al., 2025).