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Clinical features, diagnosis, and treatment of Bartonella quintana infections

David H Spach, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Bartonella quintana is a species of Bartonella, which historically caused "trench fever", but more recently has been associated with a variety of infections including bacteremia, endocarditis, and bacillary angiomatosis.

The clinical features, diagnosis, and treatment of B. quintana infection will be reviewed here. Endocarditis due to Bartonella spp, Bartonella infection in HIV-infected patients, bacillary angiomatosis, and bartonellosis (or Carrion's disease) are discussed separately. (See "Endocarditis caused by Bartonella" and "Epidemiology and clinical manifestations of Bartonella infections in HIV-infected patients" and "South American bartonellosis: Oroya fever and verruga peruana".)


B. quintana is a small, fastidious, gram-negative rod formerly known as Rochalimaea quintana, Rickettsia quintana, Rickettsia weigli, Rickettsia volhynia, and Rickettsia pediculi [1].

Early in the 20th century, B. quintana infection emerged as a major source of morbidity and mortality among soldiers and was commonly known as trench fever. During World War I, more than a million soldiers developed trench fever, and military physicians reported on the wide range of clinical manifestations [2,3].

The military physicians established the War Office Trench Fever Investigation Commission and this group identified the human body louse Pediculus humanus variety corporis as the vector for the infectious pathogen, with transmission occurring via inoculation of infected louse feces into abraded skin or conjunctivae [3]. During World War II, a significant, but less extensive, trench fever epidemic occurred. Subsequently, endemic and sporadic outbreaks of trench fever occurred in the middle part of the century in multiple regions of the world, including Ethiopia (1946), Poland (1949), Mexico (1954), USSR (1960), and Tunisia (1961) [4].

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Literature review current through: Sep 2017. | This topic last updated: Sep 27, 2017.
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