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Trench fever
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Trench fever

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Contributors: Edith Lederman MD, Noah Craft MD, PhD
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Synopsis

Trench fever, both war-related and urban, is caused by Bartonella quintana, which is transmitted by the human body louse (Pediculus humanus). This disease was first described during World War I. Although reported worldwide, it has reemerged in urban settings in Europe and the United States.

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.

Codes

ICD10CM:
A79.0 – Trench fever

SNOMEDCT:
82214002 – Trench fever

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Last Updated: 10/11/2017
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Trench fever
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Trench fever : Fever, Headache, Hepatosplenomegaly, Truncal rash, Retroorbital pain, Arthralgia, Myalgia
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