Trench fever, also known as Bartonella quintana fever or five-day fever, is a louse-borne infection caused by the gram-negative bacterium Bartonella quintana. It was first identified as a reemerging disease among poor and homeless people in the 1990s, especially during World War I, when many soldiers were afflicted with body lice and contracted trench fever. Numerous clinical problems, including persistent bacteremia, endocarditis, lymphadenopathy, and bacillary angiomatosis, are linked to the illness. 

Living in crowded, unhygienic settings predisposes people to become infested with ectoparasites that can spread the infection. Body lice prevention techniques are essential for the primary prevention of trench fever. Trench fever is often not a dangerous condition and is easily treatable, but if it is not, it can have serious side effects, such as heart problems.


Trench fever has an incubation period of 14 to 30 days, during which you can experience the following symptoms:

  • Onset fever 
  • Headache
  • Pain behind the eyes
  • Weakness 
  • Sore muscles 
  • Joint pain 
  • Shin pain 
  • Rashes around the chest


In terms of diagnosing trench fever, this disease can be identified by polymerase chain reaction (PCR) testing on tissue or blood samples, blood tests, or serological assays upon the request of the doctor. In some cases, undiagnosed symptoms cause heart problems in the long run. Furthermore, blood cultures are used to identify the bacterium, though growth can take one to four weeks. During the first attack, during relapses, throughout the asymptomatic intervals between relapses, and in patients with endocarditis, the condition is characterized by chronic bacteremia.


Despite the fact that recovery is typically complete in 1–2 months and mortality is minimal, trench fever may continue for months after clinical recovery, necessitating continued doxycycline or macrolide treatment. For four to six weeks, patients take doxycycline orally. Serious or complex infections are treated with combination therapy. The tetracycline drug doxycycline and ceftriaxone, a cephalosporin antibiotic, are two effective therapies. For those with chronic bacteremia, these medications may need to be used for a long time to provide lasting symptom alleviation. To get rid of lice that are bacterial carriers, additional treatment could be necessary.

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