Trench fever may be extremely prevalent; researchers in Marseilles were able to culture B. quintana from the blood of 14% of homeless people presenting to their university hospital emergency department. Common symptoms include headaches, anterior tibial pain, retro-orbital pain, myalgias, arthralgias, hepatosplenomegaly, truncal rash (80%-90% of patients), and fever, which cycles approximately every 5 days.
This disease is usually mild and self-limited; however, endocarditis may develop, especially in those who abuse alcohol and/or are homeless. Individuals may harbor the organism at a low level for many years, acting as a reservoir for new infections.
Individuals living in crowded, unhygienic conditions (eg, prisons, refugee camps, homeless shelters) are at the highest risk for trench fever. Epidemic typhus occurs in the same at-risk populations and is carried by the same vector; cases of outbreaks of both diseases occurring simultaneously have been reported.
Individuals with human immunodeficiency virus (HIV) infection develop a more chronic presentation with weight loss and progressively higher fevers.
A79.0 – Trench fever
82214002 – Trench fever
- Epidemic typhus patients may present with central nervous system (CNS) symptoms (seizures, coma), whereas CNS manifestations in trench fever are rare.
- The fever of brucellosis may wax and wane like that of trench fever, but marrow suppression is common with brucellosis and unusual with trench fever.
- Viral exanthem
- Typhoid fever
- Dengue fever
- Exanthematous drug eruption