UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Clinical features, diagnosis, and treatment of Bartonella quintana infections

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

INTRODUCTION

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".)

EPIDEMIOLOGY

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].

           
To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Sep 2017. | This topic last updated: Sep 27, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
References
Top
  1. Foucault C, Brouqui P, Raoult D. Bartonella quintana characteristics and clinical management. Emerg Infect Dis 2006; 12:217.
  2. Relman DA. Has trench fever returned? N Engl J Med 1995; 332:463.
  3. Anstead GM. The centenary of the discovery of trench fever, an emerging infectious disease of World War 1. Lancet Infect Dis 2016; 16:e164.
  4. Vinson JW. In vitro cultivation of the rickettsial agent of trench fever. Bull World Health Organ 1966; 35:155.
  5. Spach DH, Kanter AS, Dougherty MJ, et al. Bartonella (Rochalimaea) quintana bacteremia in inner-city patients with chronic alcoholism. N Engl J Med 1995; 332:424.
  6. Brouqui P, Lascola B, Roux V, Raoult D. Chronic Bartonella quintana bacteremia in homeless patients. N Engl J Med 1999; 340:184.
  7. Drancourt M, Mainardi JL, Brouqui P, et al. Bartonella (Rochalimaea) quintana endocarditis in three homeless men. N Engl J Med 1995; 332:419.
  8. Raoult D, Fournier PE, Drancourt M, et al. Diagnosis of 22 new cases of Bartonella endocarditis. Ann Intern Med 1996; 125:646.
  9. Spach DH, Kanter AS, Daniels NA, et al. Bartonella (Rochalimaea) species as a cause of apparent "culture-negative" endocarditis. Clin Infect Dis 1995; 20:1044.
  10. Tasher D, Raucher-Sternfeld A, Tamir A, et al. Bartonella quintana, an Unrecognized Cause of Infective Endocarditis in Children in Ethiopia. Emerg Infect Dis 2017; 23.
  11. Koehler JE, Sanchez MA, Garrido CS, et al. Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis. N Engl J Med 1997; 337:1876.
  12. Relman DA, Loutit JS, Schmidt TM, et al. The agent of bacillary angiomatosis. An approach to the identification of uncultured pathogens. N Engl J Med 1990; 323:1573.
  13. Rolain JM, Foucault C, Guieu R, et al. Bartonella quintana in human erythrocytes. Lancet 2002; 360:226.
  14. Jackson LA, Spach DH, Kippen DA, et al. Seroprevalence to Bartonella quintana among patients at a community clinic in downtown Seattle. J Infect Dis 1996; 173:1023.
  15. Brouqui P, Houpikian P, Dupont HT, et al. Survey of the seroprevalence of Bartonella quintana in homeless people. Clin Infect Dis 1996; 23:756.
  16. Guibal F, de La Salmonière P, Rybojad M, et al. High seroprevalence to Bartonella quintana in homeless patients with cutaneous parasitic infestations in downtown Paris. J Am Acad Dermatol 2001; 44:219.
  17. Brouqui P, Stein A, Dupont HT, et al. Ectoparasitism and vector-borne diseases in 930 homeless people from Marseilles. Medicine (Baltimore) 2005; 84:61.
  18. Comer JA, Flynn C, Regnery RL, et al. Antibodies to Bartonella species in inner-city intravenous drug users in Baltimore, Md. Arch Intern Med 1996; 156:2491.
  19. ITO S, VINSON JW. FINE STRUCTURE OF RICKETTSIA QUINTANA CULTIVATED IN VITRO AND IN THE LOUSE. J Bacteriol 1965; 89:481.
  20. Raoult D, Roux V. The body louse as a vector of reemerging human diseases. Clin Infect Dis 1999; 29:888.
  21. Rydkina EB, Roux V, Gagua EM, et al. Bartonella quintana in body lice collected from homeless persons in Russia. Emerg Infect Dis 1999; 5:176.
  22. Raoult D, Ndihokubwayo JB, Tissot-Dupont H, et al. Outbreak of epidemic typhus associated with trench fever in Burundi. Lancet 1998; 352:353.
  23. Bonilla DL, Kabeya H, Henn J, et al. Bartonella quintana in body lice and head lice from homeless persons, San Francisco, California, USA. Emerg Infect Dis 2009; 15:912.
  24. La Scola B, Fournier PE, Brouqui P, Raoult D. Detection and culture of Bartonella quintana, Serratia marcescens, and Acinetobacter spp. from decontaminated human body lice. J Clin Microbiol 2001; 39:1707.
  25. Seki N, Kasai S, Saito N, et al. Quantitative analysis of proliferation and excretion of Bartonella quintana in body lice, Pediculus humanus L. Am J Trop Med Hyg 2007; 77:562.
  26. Raoult D, Drancourt M, Carta A, Gastaut JA. Bartonella (Rochalimaea) quintana isolation in patient with chronic adenopathy, lymphopenia, and a cat. Lancet 1994; 343:977.
  27. Chomel BB, Kasten RW, Stuckey MJ, et al. Experimental infection of cats with Afipia felis and various Bartonella species or subspecies. Vet Microbiol 2014; 172:505.
  28. Kernif T, Leulmi H, Socolovschi C, et al. Acquisition and excretion of Bartonella quintana by the cat flea, Ctenocephalides felis felis. Mol Ecol 2014; 23:1204.
  29. Leulmi H, Bitam I, Berenger JM, et al. Competence of Cimex lectularius Bed Bugs for the Transmission of Bartonella quintana, the Agent of Trench Fever. PLoS Negl Trop Dis 2015; 9:e0003789.
  30. Li H, Bai JY, Wang LY, et al. Genetic diversity of Bartonella quintana in macaques suggests zoonotic origin of trench fever. Mol Ecol 2013; 22:2118.
  31. Ohl ME, Spach DH. Bartonella quintana and urban trench fever. Clin Infect Dis 2000; 31:131.
  32. Vinson JW, Varela G, Molina-Pasquel C. Trench fever. 3. Induction of clinical disease in volunteers inoculated with Rickettsia quintana propagated on blood agar. Am J Trop Med Hyg 1969; 18:713.
  33. Koehler JE, Quinn FD, Berger TG, et al. Isolation of Rochalimaea species from cutaneous and osseous lesions of bacillary angiomatosis. N Engl J Med 1992; 327:1625.
  34. Drancourt M, Moal V, Brunet P, et al. Bartonella (Rochalimaea) quintana infection in a seronegative hemodialyzed patient. J Clin Microbiol 1996; 34:1158.
  35. LeBoit PE, Berger TG, Egbert BM, et al. Bacillary angiomatosis. The histopathology and differential diagnosis of a pseudoneoplastic infection in patients with human immunodeficiency virus disease. Am J Surg Pathol 1989; 13:909.
  36. LeBoit PE, Berger TG, Egbert BM, et al. Epithelioid haemangioma-like vascular proliferation in AIDS: manifestation of cat scratch disease bacillus infection? Lancet 1988; 1:960.
  37. Zeaiter Z, Fournier PE, Greub G, Raoult D. Diagnosis of Bartonella endocarditis by a real-time nested PCR assay using serum. J Clin Microbiol 2003; 41:919.
  38. Diaz MH, Bai Y, Malania L, et al. Development of a novel genus-specific real-time PCR assay for detection and differentiation of Bartonella species and genotypes. J Clin Microbiol 2012; 50:1645.
  39. Angelakis E, Raoult D. Pathogenicity and treatment of Bartonella infections. Int J Antimicrob Agents 2014; 44:16.
  40. Foucault C, Raoult D, Brouqui P. Randomized open trial of gentamicin and doxycycline for eradication of Bartonella quintana from blood in patients with chronic bacteremia. Antimicrob Agents Chemother 2003; 47:2204.
  41. Raoult D, Fournier PE, Vandenesch F, et al. Outcome and treatment of Bartonella endocarditis. Arch Intern Med 2003; 163:226.
  42. Rolain JM, Brouqui P, Koehler JE, et al. Recommendations for treatment of human infections caused by Bartonella species. Antimicrob Agents Chemother 2004; 48:1921.