Bartonella Quintana infection can be contracted through the bite of a human body louse. Body lice are distributed through close physical contact or by recurrently wearing or sleeping in the same bedding and clothes. In regions with a high population density and poor hygiene, Bartonella Quintana infection is most frequently associated with body louse outbreaks.

People who are homeless are more likely to become infected with B. Quintana due to the limited availability of restrooms and laundry amenities. Bartonella Quintana infection happens worldwide. Because of the high number of cases among soldiers living in crowded trenches in filthy conditions during World War I, infection was termed “trench fever.”


Bartonella Quintana infection appears suddenly after a 14 to 30-day incubation period, with fever, dizziness, weakness, headache, conjunctival injection, and serious back and leg pains. Fever can reach 40.5°C and last 5 to 6 days. It will repeat 1 to 8 times at 5- to 6-day intervals in approximately half of the cases.

A transient papular and macular rash, as well as splenomegaly and hepatomegaly, may occur. Some cases may be complicated by endocarditis. Also, relapses are prevalent and can happen up to ten years after the initial attack.


A doctor will ask about your symptoms and review your medical history to determine if you have the infection.

Following that, the doctor will conduct the following tests:

  • Serologic tests and PCR testing
  • Blood cultures

Bartonella Quintana infection must be suspected in individuals who live in areas with a high level of louse infestation.

Blood culture is used to identify the organism, though growth can take 1 to 4 weeks. Continual bacteremia occurs during the preliminary attack, relapses, asymptomatic durations between relapses, and in individuals with endocarditis.

Serologic testing is offered and can help with the diagnosis. High IgG antibody titers should prompt a cardiac echocardiogram to rule out endocarditis. Blood or tissue samples can be tested using PCR.


Antibiotics are required for Bartonella Quintana infection. Aminoglycosides, tetracyclines, and macrolides are among the antibiotics that are effective against Bartonella infections. Multiple antibiotics are frequently utilized.

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