Journal Article

<i>Bartonella quintana</i> and Urban Trench Fever

Michael E. Ohl and David H. Spach

Edited by Larry J. Strausbaugh

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 1, pages 131-135
Published in print July 2000 | ISSN: 1058-4838
Published online July 2000 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/313890
Bartonella quintana and Urban Trench Fever

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Contemporary Bartonella quintana infections have emerged in diverse regions of the world, predominantly involving socially disadvantaged persons. Available data suggest that the human body louse Pediculus humanus is the vector for transmission of B. quintana. Descriptions of the clinical manifestations associated with contemporary B. quintana infections have varied considerably and include asymptomatic infection, a relapsing febrile illness, headache, leg pain, “culture-negative” endocarditis, and, in human immunodeficiency virus—infected persons, bacillary angiomatosis. Laboratory diagnosis is most convincing when B. quintana is isolated in blood culture, but growth often takes 20–40 days; problems exist with both sensitivity and specificity of serological assays. On the basis of available information, use of doxycycline, erythromycin, or azithromycin to treat B. quintana infections is recommended. Treatment of uncomplicated B. quintana bacteremia for 4–6 weeks and treatment of B. quintana endocarditis (in a person who does not undergo valve surgery) for 4–6 months are recommended, with the addition of a bactericidal agent (such as a third-generation cephalosporin or an aminoglycoside) during the initial 2–3 weeks of therapy for endocarditis.

Journal Article.  4133 words. 

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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