This disease 1st reported in trenches of the Western Front on December 1914 (World War 1). It gets its name (Trench fever) when many armies (German and its allied troops) fighting in the European trenches harbored infested body lice. (http://wwwnc.cdc.gov/eid/article/12/2/05-0874_article.htm)Also calledquintan, shin fever, and 5-day fever.
B.quintana originally isolated in the 1960s and was initially placed in the genus Rickettsia and then Rochalimaea.Quintana derives from the form of illness characterized by recurring fever every fifth day. It has typical gram-negative cell wall but stains poorly with Graim’s stain. B.quintanais an aerobic, non-motile, short bacillary or cocobacillary organism. It’s able to survive for prolonged period in dried louse feces.
Hadfield, T.L.,et al.1993Endothelial cells: cells that line the interior surface of blood vessels and lymphatic vessels.Nuclear atypia: abnormal appearance of cell nuclei
Also known as P. humanushumanus. (Phthiraptera-sucking lice) – hemimetabolous insects which have 3 distinct stages: egg-nymph-adult. No pupal stage.
Nits are the lice eggs, cemented at the base of hair shaft near skin. Take 1 week to hatch. Nymph look like adult body lice but is about the size of a pinhead. Mature after 3 molts. Becomes adult around 7 days after hatching.Adult body lice are about the size of sesame seed. Need blood meal several times a day. Without blood meal, they will die 1-2 days off the host.
http://www.businessinsider.com/homeless-shelter-photos-2012-1?IR=T& - shelter of homeless people in USA.http://sniffandflehmen.tumblr.com/post/78993226/sanitation-in-Africa – poor sanitation in Africa.
After Word War 1, trench fever appeared from Europe, Asia and North Africa, followed by outbreaks of disease during World War 2. The reemerge of trench fever in the central African camps highlights the appalling conditions of the camps and failure of public health. In February 1997, national refugee population was estimated to be over 700, 000. At least 28 camps were established and in most no health care was available. They were set up in remote areas away from town where it was hard to access for medical help. Most refugees had few clothes and probably due to low ambient temperature, they seldom changed or washed the clothes. (in addition to the crowded population & poor sanitation) –caused the epidemic to erupted.
Hepatosplenomegaly-simultaneously enlargement of both liver and spleen.http://www.skinsight.com/atlas/trenchFever.htmhttp://www.pharmacy-and-drugs.com/Heart_diseases/Endocarditis.htmlhttp://wwwnc.cdc.gov/eid/article/12/2/05-0874_article.htm
traditional Gram-negative antibacterial therapeutic agents that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside (sugar).
NURFARAH AIN LIMIN (P74703)
An acute febrile illness caused by a gram-negative
bacterium known as Bartonella quintana
(Relman, D. A., 1995)
Trench fever first reported during World War 1, when
approximately 1 million soldiers developed this disease
(Byam, W., 1919)
PATHOGEN OF TRENCH FEVER
B. quintana has typical gram-
negative cell wall but stains
poorly with Gram’s stain
B. quintana is an aerobic, non-
motile, short bacillary
organism. It’s able to survive
for prolonged period in dried
(Relman, D. A., 1995)
cells and can
with a large
they begin to
This leads to
result in chills,
microscopy showing the
location of Bartonella
Magnification × 400
Infectious Diseases. 2006;
Centers for Disease
Control and Prevention
VECTORS of B. quintana
Body lice (Pediculus humanus corporis) are
the vectors of B. quintana
B.quintana is transmitted when an infected
louse excretes the bacterium onto the
The excretion is then scratched or rubbed
into the skin
(Vinson, J. W., et al., 1969)
Infection with B.quintana is associated with:
Alcoholism in poor people
(Spach, D. H., et al., 1995)
Trench fever has appeared in every
continent except Australia and
Antartica since the first appearance in
World War 1 (Maurin, M., et al., 1996)
In 1997, an epidemic of trench fever
erupted in refugee camps in Burundi,
Africa (Raoult, D., et al., 1998)
Prevalence of B.quintana
infestation on homeless population
Country Percentage (%)
United States of America
(Brouqui, P., et al., 1999)
Some patients developed
“classic trench fever
Bone pain (mainly in shins)
Neck and back pain
Pain behind the eyes
Relapsing febrile illness
(recurrent fever, usually
every fifth day)
Endocarditis (inflamed of
involve heart valve)
(swollen lymph nodes)
(Foucault, C., et al., 2006)
B.quintana is sensitive to antibiotics such as:
Aminoglycosides – 1st line treatment for Bartonella
infections because it has bactericidal effect
(Myers, W. F., et al., 1984)
Avoid exposure to human body
lice typically in crowded condition
and limited access to proper
Wear clean clothes and wash them
Vinson, J. W., Varela, G. and Molina-Pasquel, C. (1969) Trench Fever.
111. Induction of clinical disease in volunteers inoculated with
Rickettsia quintana propagated on blood agar. The American
Journal of Tropical Medicine and Hygiene, 18, 713-722.
Relman, D. A. (1995) Has trench fever returned? The New England
Journal and Medicine, 332, 463-464.
Spach, D.H., Kanter, A. S., Dougherty, M. J. et al. (1995) Bartonella
(Rochalimaea) quintana bacteremia in inner-city patients with
chronic alcoholism. The New England Journal of Medicine, 332, 424-
Byam,W. (1919) Trench fever. London: Henry Frowde and Hodder &
Raoult, D. Ndihokubwayo, J. B., Tissot-Dupont, H. et al. (1998).
Outbreak of epidemic typhus associated with trench fever in
Burundi. Lancet, 352, 353-358.