Trench fever may be extremely prevalent; researchers in Marseilles were able to culture B. quintana from the blood of 14% of undomiciled 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 undomiciled. 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, 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