Trench fever

**Definition:** A disease caused by an infection with the gram-negative bacteria Bartonella quintana. This disease is characterised by fever, headache, rash, bone pain, or may be asymptomatic. Transmission is through the bite of infected body lice. Confirmation is by identification of Bartonella quintana in a blood sample. Bartonella quintana was formerly known as Rickettsia quintana.

**Long definition:** Trench fever is due to an infection by Bartonella quintana usually transmitted by the human body louse. A disease associated with poor sanitation in First World War trenches, trench fever may now be found amongst the homeless or alcoholic urban poor. It begins with chills and fever after an incubation period of a few days to a month. Occasionally, the patient experiences only a single febrile episode that lasts 4 or 5 days. More commonly, several episodes of fever occur. Each episode lasts about 5 days, which is the origin of the designation quintana. The patient cycles between severe chills and profuse sweating. In other patients, continuous fever lasts 2-6 weeks.

**Inclusions:** - Quintan fever