what was trench fever and how was it caused?

Utility of Molecular Identification and Quantitation of Bartonella Species with Species-Specific Real-Time PCR for Monitoring Treatment Response: A Case Series. [QxMD MEDLINE Link]. Other possible vectors include mites, ticks, and fleas. Our editors will review what youve submitted and determine whether to revise the article. [1, 2] Rickettsia -like organisms in the body and feces of P humanus were postulated to be the cause. The condition was first described during World War I, when it affected nearly 1 million soldiers. Episode 32 out now! Cases of urban trench fever described since 1995 have also predominantly involved males, reflecting the disproportionate representation of males in the homeless alcoholic population. Trench fever | Definition, Cause, Symptoms, and Treatment Trench fever | definition of trench fever by Medical dictionary [20, 31, 32, 33, 34, 35, 36] Cases of culture-negative endocarditis with antibody titers positive for B quintana have been reported in Europe, Australia, Japan, Tunisia, and India. Bartonella quintana is predominantly carried by a vector, the body louse. "The so-called cat-scratch disease is another . [1, 2] (see the image below). Ceftriaxone and fluoroquinolones may also be considered as an alternative therapy. Endocarditis: doxycycline 100 mg orally twice daily for six weeks combined with gentamicin 3 mg/kg/day intravenous for 14 days. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. What Are the Self-Care Methods That Can Be Undertaken? If an itchy rash is present, scratching must be avoided, as this may lead to further infection with other bacteria. The vector through which the disease is typically transmitted is referred to as the human body louse "Pediculus humanus humanus", which is better known as lice. Hare HA, ed. 6 Go to: SEARCH FOR A CAUSE Brouqui P, Houpikian P, Dupont HT, Toubiana P, Obadia Y, Lafay V, et al. 2003 May. In addition, B quintana DNA was found in a 4000-year-old human tooth in Roaix, France. See Treatment and Medication for more details. Schnitzler syndrome is a systemic disorder affecting the adult population and is more common among men. Matera G, Liberto MC, Joosten LA, Vinci M, Quirino A, Pulicari MC, et al. 2008 Sep. 19(3):113-8. [QxMD MEDLINE Link]. The louse-borne human pathogen Bartonella quintana is a genomic derivative of the zoonotic agent Bartonella henselae. La VD, Tran-Hung L, Aboudharam G, Raoult D, Drancourt M. Bartonella quintana in domestic cat. Foucault C, Brouqui P, Raoult D. Bartonella quintana characteristics and clinical management. Trench fever is called a five-day fever because the symptoms last for four to five days, and the fever can reoccur every five days. [5] . Induction of clinical disease in volunteers inoculated with Rickettsia quintana propagated on blood agar. 75(10):4831-7. Trench Fever is a louse-borne disease that affects humans. [1] The War Office Trench Fever Investigation Commission could not prove if trench fever was caused by bacteria or protozoa. Am J Pathol. Se puede reimprimir una sola copia de estos materiales para usar en forma personal y no comercial. Medicine on the British sector of the Western Front, 1914-1918 This process k Read Article, Article Overview: The medical terminology for inflamed gums is 'gingivitis'. Trench fever is now seen around the world, usually among populations that live close together and or with bad sanitary conditions. Trench Fever - Infectious Diseases - The Merck Manuals Balakrishnan N, Menon T, Fournier PE, Raoult D. Bartonella quintana and Coxiella burnetii as causes of endocarditis, India. No convincing data suggest that urban trench fever or other syndromes caused by B quintana infection have a racial or ethnic predilection. Trench Fever: What to Know About Rare Disease Spread by Lice - Health [QxMD MEDLINE Link]. Trench fever was first described and reported by British major John Graham in June 1915. 1. [Full Text]. Kernif T, Leulmi H, Socolovschi C, Berenger JM, Lepidi H, Bitam I, et al. Lancet. Proc Natl Acad Sci U S A. 1 In some cases, subacute endocarditis may al. Emerg Infect Dis. 1999 Aug. 29(2):434-6. Bartonella quintana and urban trench fever. Once they get swollen, there is redness, puffiness, and bleeding of gums. [QxMD MEDLINE Link]. The vector (louse) reproduces in the person's intestinal lumen and transmits the disease by inoculating contaminated feces into the conjunctiva or exposed skin. Antimicrob Agents Chemother. The human body louse Pediculus humanus var corporis is the major vector involved in trench fever transmission It is found to occur at the age of 51 years. Kernif T, Leulmi H, Socolovschi C, Berenger JM, Lepidi H, Bitam I, et al. Bonilla DL, Kabeya H, Henn J, Kramer VL, Kosoy MY. Medicine (Baltimore). LaScola B, Raoult D. Culture of Bartonella quintana and Bartonella henselae from human samples: a 5-year experience (1993 to 1998). 2. Language links are at the top of the page across from the title. The differential diagnosis list includes typhus, ehrlichiosis, leptospirosis, Lyme disease, and virus-caused exanthema (measles or rubella). June/1994. Rolain JM, Broqui P, Koehler JE, Maguina C, Dolan MJ, and Raoult D. Recommendations for treatment of human infections caused by Bartonella species. Detection of Bartonella quintana in African body and head lice. Antibiotic treatment protocols differ based on the disease presentation: Trench fever and chronic bacteremia: Doxycycline (oral) 200 mg for 28 days along with Gentamicin (IV) 3 mg/kg/day for 14 days. 'Trench fever' found in teeth of ancient Romans reveals the disease However, the disease is most prevalent in humans as they are the primary host of the bacteria causing trench fever. [13] Recovery takes a month or more. Clin Infect Dis. Biswas S, Rolain JM. Feb/2003. In 1918, two commissions identified that the disease was louse-borne. ECDC: On Air - podcast on European epidemiology. Trench fever, bacteremia, endocarditis, chronic lymphadenopathy, and bacillary angiomatosis can be caused by: Bartonellaquintana. Contemporary descriptions of B quintana endocarditis in homeless alcoholic males have found mortality rate to be as high as 12%, with most deaths related to complications of endocarditis or to the surgery used in its treatment. Regarding serological test, indirect immunofluorescence assay is the reference method. Facts about Bartonella quintana infection ('trench fever') 2005 Jan. 84 (1):61-8. Mazzitelli M, Lamberti AG, Quirino A, Marascio N, Barreca GS, Costa C, et al. Medscape Education, Immunization Against Dengue: The Accumulated Clinical Trial Data, encoded search term (Trench Fever) and Trench Fever, WHO Prepares for El Nino-Linked Spread of Viral Disease, Antibody-Drug Conjugates and Subgroups of Advanced and Metastatic Breast Cancer: Strategies, Resistance, Emerging Data, Climate Change May Promote the Global Spread of Arboviruses, Experts Decry CDC's Long Pause on Neglected Tropical Disease Testing, Clinical Trial Begins for New Drug to Combat Neglected Tropical Diseases. 2012 Jan;18(1):163-5. 163(2):226-30. Epidemiological studies on Bartonella quintana infections among homeless people in Tokyo, Japan. Differential diagnoses vary according to the clinical presentation, and include: Trench fever: louse-borne and tick-borne relapsing fever, infection due to. Bacillary angiomatosis: Kaposi sarcoma, pyogenic granuloma, or Peruvian wart (. Some (but not all) persons with urban trench fever have evidence of louse infestation. trench fever, also called quintana fever or five-day fever, infectious disease characterized by sudden onset of fever, headache, pain behind the eyes, weakness, sore muscles and joints, and often severe pain in the back and shins. [4][12] Aftereffects may include neurasthenia, cardiac disturbances, and myalgia. [QxMD MEDLINE Link]. The TFIC performed experiments with infected blood and louse and learned much about the disease and louse behavior. Treatment is with a macrolide or doxycycline. Trench fever was finally accepted as a clinical syndrome that occurred with enough consistency and frequency to justify its classification as a specific disease. Myers WF, Grossman DM, Wisseman CL Jr. Emerg Infect Dis. Homeless people, either those in shelters or people with no access to clean clothes. Three additional syndromes are associated with B quintana infection, as follows: Chronic lymphadenopathy Enlarged cervical lymph nodes, without fever or other associated symptoms, Bacillary angiomatosis characteristic skin lesions, with or without regional lymphadenopathy, B quintana endocarditis Fever, new murmur, and heart failure; embolic phenomena. What is Trench Fever|Causes|Symptoms|Treatment|Risk - Epainassist Human diseases that have been identified to be caused by one of the Bartonella spp bacteria include cat scratch disease ( Bartonella henselae ), Carrion's disease ( Bartonella bacilliformis ), and trench fever ( Bartonella quintana ). Endocarditis: HACEK group infections, fastidious growing streptococci endocarditis, legionellosis and Q fever. [3] Trench fever episodes may involve loss of appetite, shin pain or tenderness, and splene enlargement. 2005 Aug. 11(8):1287-9. A.Milne,[5] and C. S. Even after recovering from trench fever, the disease can reoccur up to ten years after the initial attack. [20] The MRC and TFIC findings were very similar essentially confirming the louse as the vector of transmission. The author would like to thank A Clinton White, MD, for his encouragement and suggestions during the composition of this article. The initial fever is usually followed in a few days by a single, short rise but there may be many relapses between periods without fever. Arch Intern Med. [QxMD MEDLINE Link]. The centenary of the discovery of trench fever, an emerging infectious Read Article, Introduction: J Clin Microbiol. 7. [22], Despite this possible immunologic association, the histologic features of these two clinical variants differ. Future Microbiol. 4. Therefore, another diagnostic method is serological testing for identifying the organism. [10, 15, 16], The human body louse P humanus var corporis is the major vector involved in trench fever transmission (see the image below). They can also be washed and dried at temperatures above 60C. Let us know if you have suggestions to improve this article (requires login). B quintanarelated illness has been found on every continent except Antarctica. [3][12], Serological testing is typically used to obtain a definitive diagnosis. Bartonella species bacteria cause a range of diseases, including cat scratch disease (CSD), caused by B. henselae; trench fever, caused by B. quintana; Carrin disease (Oroya fever and verruga peruana), caused by B. bacilliformis; and bacillary angiomatosis (BA), caused by B. henselae or B. quintana. Por lo general, se entiende que una persona tiene fiebre si, al tomarle la temperatura con un termmetro oral, la temperatura en la boca es de 100 grados Fahrenheit (37,8 grados Celsius) o ms. For 3 years, the transmission and cause of trench fever were hotly debated. Dehio C. Molecular and cellular basis of bartonella pathogenesis. Sept /2006. Ehrenborg C, Bystrm R, Hjelm E, Friman G, Holmberg M. High Bartonella spp. It is difficult, however, to ascertain the true incidence of urban trench fever, as most infected individuals are asymptomatic. Clin Microbiol Rev. Updates? Lancet. Trench fever is transmitted through the feces of body lice, which can be left on clothing. Skin diseases associated with Bartonella infection: facts and controversies. The British Expeditionary Force Pyrexia of Unknown Origin Enquiry Sub-Committee concluded that the specific means by which the vector infected the host was louse waste entering the body through abraded skin. [21] These changes result in systemic symptoms, bacteremia, endovascular infection, and lymphatic enlargement. Emerg Infect Dis. In 1917, the Trench Fever Investigation Commission (TFIC) had its first meeting. The disease is caused by the bacterium Bartonella quintana (older names: Rochalimea quintana, Rickettsia quintana), found in the stomach walls of the body louse. Oct, 2003. Antimicrob Agents Chemother. Int J Infect Dis. When a person has trench fever, they have a fever (up to 40.5 degrees Celsius) that lasts for five days and occurs almost one to eight times in the five-day cycle, along with rashes on the chest. Dorsal view of female body louse, Pediculus humanus var corporis. How Is Erectile Dysfunction Due to Venous Leak Treated? The term urban trench fever is applied to contemporary B quintana disease. [QxMD MEDLINE Link]. [6, 7] Reports of trench fever outbreaks stopped after World War I and then reappeared transiently on the Eastern Front in Europe during World War II. Emergence of Bartonella quintana infection among homeless persons. The incubation period is relatively long, at about two weeks. J Infect. 19. [4, 5, 1, 2] It has been known by several different names, including quintan fever, 5-day fever, shin bone fever, tibialgic fever, Wolhynia fever, and His-Werner disease. Chomel BB, Boulouis HJ, Breitschwerdt EB, Kasten RW, Vayssier-Taussat M, Birtles RJ, et al. Information on efficacy of treatment is limited due to the small number of studies available and so choice of treatment relies on expert recommendations. Cause Body lice spread trench fever, but the disease itself was caused by the bacterium Bartonella quintana. [17] Intraerythrocytic B quintana colonization is largely limited to human beings, version 12.066-7-prod. Annu Rev Microbiol. It is one of the most common oral health concerns we face. [10, 8] Humans are the predominant reservoir of the pathogen, although infection has been documented in some nonhuman primates and in cats. Sarpullido. Emerg Infect Dis. Trench fever usually lasts for five days, with recurrent episodes in every five-day cycle. 2013 Oct. 17(10):e811-9. Trench Fever Treatment & Management: Approach Considerations - Medscape 2008. Occurrence of Bartonella henselae and Bartonella quintana in a healthy Greek population. Chapter 32: Bartonella and Afipia Flashcards | Quizlet Seki N, Sasaki T, Sawabe K, Sasaki T, Matsuoka M, Arakawa Y, et al. Chronic bacteraemia is possible due the ability of. Effective treatments include doxycycline, a tetracycline antibiotic, and ceftriaxone, a cephalosporin antibiotic. Oral ivermectin for body delousing has been proposed for populations with low compliancy but does not protect from lice reinfestation. Trench Fever: Practice Essentials, Background, Pathophysiology - Medscape The process is used worldwide for milk, both by the food industry and at home. Vol 1: 151-244. Dolor de cabeza. The authors and editors of Medscape Reference also gratefully acknowledge the contributions of previous author Eleftherios Mylonakis, MD, and previous coauthor Michael Forgione, MD, to the development and writing of this article. Read Article, What Is the Process of Pasteurization? Cerimele F, Brown LF, Bravo F, Iher GM, Kouadio P, Arbiser JL, et al. Trench fever was also held responsible for disordered action of the heart, which presented as exhaustion, dyspnoea, palpitations, precordial pain, giddiness, and fainting. [QxMD MEDLINE Link]. Most persons recover within about two months; there may be relapses, however, and the disease becomes chronic in a small percentage of cases. Trench Mouth: What It Is, Symptoms & Treatment - Cleveland Clinic Drancourt M, Tran-Hung L, Courtin J. Bartonella quintana in a 4000-year-old human tooth. Acta Trop. Trench fever, also known as "five-day fever", is a disease caused by the gram-negative bacterium Bartonella quintana that is louse-borne and was observed originally in military populations during World War I and II. John L Brusch, MD, FACP Corresponding Faculty Member, Harvard Medical School (David Donnelly/CBC) An infectious diseases specialist is calling on doctors to be aware of the signs of . JID. Trench fever (also known as "five-day fever", "quintan fever" (Latin: febris quintana), and "urban trench fever") is a moderately serious disease transmitted by body lice. Magnolato A, Pederiva F, Spagnut G, Maschio M, Ventura A, Taddio A. Tea A, Alexiou-Daniel S, Arvanitidou M, Diza E, Antoniadis A. Foucault C, Barrau K, Brouqui P, Raoult D. Bartonella quintana Bacteremia among Homeless People. 191(4):607-11. Infect Immun. 25:690-3. Ruhrah J. Possible causes of symptoms in 3 mins 2008 Jun. Trench fever: the British medical response in the Great War Occasionally, hepatomegaly and splenomegaly are associated. 2002 Sep 15;35(6):684-9. 163:1321-7. Because trench fever was historically an infection of soldiers, most of the cases documented during World Wars I and II were in males. Oral Ivermectin has been proposed for delousing among populations with low compliance but does not protect from reinfestation. Humans are considered to be the main host for this organism, but several researchers have reported the identification of the bacteria in mammals (macaques, cats, and dogs). Open Microbiol J. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. [QxMD MEDLINE Link]. 18. [QxMD MEDLINE Link]. Most of the time, trench fever is a self-limited illness. Diagnosis is made via blood culture. PLoS Negl Trop Dis. [QxMD MEDLINE Link]. Foucault C, Barrau K, Brouqui P, Raoult D. Bartonella quintana Bacteremia among Homeless People. Vmitos. Click here, +91-99-432-70000+1 (844) 432-0202 (Toll free for US & Canada), Published on Aug 26, 2022 During World War II, the British Government commissioned sheep dip manufacturer, Cooper, McDougall & Robertson of Berkhamsted, Herts to develop a product which troops could use to ward off lice. By continuing, you agree to our terms of use and privacy policy. Molecular detection of Bartonella species in ticks from Peru. Trench fever transmission is more rapid in overcrowded areas, homeless people, and those living in poor hygienic conditions. Kostrzewski J. B quintana was found in the lice of 33.3% of body liceinfested and 25% of head liceinfested homeless persons in California. It infected armies in Flanders , France , Poland , Galicia , Italy , Macedonia , Mesopotamia , Russia and Egypt in World War I . Polymerase chain reaction (PCR) testing of blood or tissue samples can be done. Mem Inst Oswaldo Cruz. Some of those infected can develop skin lesions or a life . 2006 Jan 1. [Full Text]. 1949. Rolain JM, Foucault C, Guieu R, Lascola B, Brouqui P, Raoult D. Bartonella quintana in human erythrocytes. Trench fever needs medical intervention if symptoms are present in a person to avoid serious complications. People started using the term "trench mouth" during World War I, when soldiers living and fighting in battlefield trenches developed severe gum infections linked to poor diet, poor oral hygiene and intense psychological stress. Dengue - Sntomas y causas - Mayo Clinic [QxMD MEDLINE Link]. Schulte B, Linke D, Klumpp S, Schaller M, Riess T, Autenrieth IB, et al. Trench Fever. [QxMD MEDLINE Link]. In immunocompromised hosts, however, B quintana infection tends to be more severe and may result in death. [28] Contamination of mucous membranes, transfusion, transplantation, and IV drug abuse are also potential avenues of entry. [10], B quintana bacteremia may be intermittent or prolonged for years, suggesting that blood-sucking arthropods are efficient transmitters of B quintana infection. Measures are taken to control the body louse. 12. CLSI. What Is Trench Fever? - iCliniq 2003 Jul. 1996 Jul. Some patients will require treatment, and others will not. [QxMD MEDLINE Link]. Bartonellosis - Symptoms, Causes, Treatment | NORD 5. Hawaii Med J. 35(6):684-9. Analysis of the first Australian strains of Bartonella quintana reveals unique genotypes. [6] From 1915 to 1918 between one-fifth and one-third of all British troops reported ill had trench fever while about one-fifth of ill German and Austrian troops had the disease. For those who do require treatment, the best treatment comes by way of doxycycline in combination with gentamicin. [QxMD MEDLINE Link]. The disease may be diagnosed through blood or serological tests, as well as through polymerase chain reaction (PCR) testing of tissue or blood samples. seroprevalence in a Swedish homeless population but no evidence of trench fever. The term trench fever refers to the crowded conditions in which troops fought in during World War I and World War II. US stocks fall as private payroll data suggests more Fed rate hikes are Blood transfusion as an alternative bartonellosis transmission in a pediatric liver transplant. Is trench mouth a common condition? In 1915, allied soldiers in the trenches of the Western Front began to. Sntomas y causas - Mayo Clinic [10] The pathogenesis of B quintana associated disease suggests that bacteremia is an early occurrence common to all of the various syndromes attributed to it. The so-called "trench fever.". [20], Once the organism invades and begins to multiply within endothelial cells, proinflammatory cytokines are activated, apoptosis suppressed, and vascular proliferation initiated. J Clin Microbiol. Bacillary angiomatosis due to B. quintana was mainly reported among immunodeficiency virus-infected persons in the 1990s, but can affect other immunocompromised individuals. [29] In one study, 20% of the patients in a downtown Seattle clinic that serves a homeless indigent population had microimmunofluorescent antibody titers of 1:64 or greater to Bartonella species. Bartonella quintana endocarditis with positive serology for Coxiella burnetii. Is it possible to get syphilis through kissing? Clin Infect Dis. Characteristics of classic trench fever were fairly consistent, as follows: Toxic initial appearance associated with prostration, Characteristic blanching, erythematous, macular rash, Paroxysmal tachycardia, paralleling the fever and exacerbated with exercise. Brouqui P, Lascola B, Roux V, Raoult D. Chronic Bartonella quintana bacteremia in homeless patients. Detection of Bartonella (Rochalimaea) quintana by routine acridine orange staining of broth blood cultures. 44 Questions from Britannicas Most Popular Health and Medicine Quizzes, This article was most recently revised and updated by, https://www.britannica.com/science/trench-fever, University of Kansas Medical Center - Trench Fever in the First World War, trench fever - Student Encyclopedia (Ages 11 and up). 'Cat Scratch' Bacteria Linked to Psychiatric Symptoms in People - Gizmodo Antibiotic susceptibility patterns in Rochalimaea quintana, the agent of trench fever. There have also been reports of an infected louse bite passing on the infection. Principles and Procedures for Blood Cultures: Approved Guidelines. 2009 Jun. 23(5):1204-12. Trench Fever That Affected Tolkien, C.S. Lewis Could Be - Newsweek 2010 Nov. 5(11):1719-31. Yoda M, Hata M, Sezai A, Unosawa S, Furukawa N, Minami K. First report of Bartonella quintana endocarditis in Japan. B. quintana is transmitted to humans when feces from infected lice are rubbed into abraded skin or the conjunctiva. Do lice spread disease? 1999 Oct;29(4):888-911. [10] A 2014 study showed that cat fleas (Ctenocephalides felis) can ingest B quintana and release viable bacteria into their feces. Sangare AK, Boutellis A, Drali R, Socolovschi C, Barker SC, Diatta G, et al. Epidemiologic and clinical characteristics of Bartonella quintana and Bartonella henselae endocarditis: a study of 48 patients. The disease transmission can also occur through an infected person's clothes, bedding, and fomites. trench fever, also called quintana fever or five-day fever, infectious disease characterized by sudden onset of fever, headache, pain behind the eyes, weakness, sore muscles and joints, and often severe pain in the back and shins. J Clin Micro. In most immunocompetent hosts, B quintana infection is self-limited unless endocarditis occurs. 2010 Mar. [citation needed], Trench fever is a vector-borne disease in which humans are primarily the main hosts. It was first observed among the military population during World War I and World War II (hence the name 'Trench Fever') (1).It is a bacterial disease caused by a gram-negative bacterium called Bartonella quintana (also called as Rochalimaea quintana) found within the stomach walls of body louse. Transpl Infect Dis. Clin Infect Dis. 72(5):503-7. Trench mouth affects about 0.5% to 11% of the population. The three most common are cat scratch disease, caused by B. henselae; trench fever, caused by B. quintana; and Carrin's disease, caused by B. bacilliformis. Am J Trop Med Hyg. Antibiotic treatment protocols are different according to the disease presentation: Trench fever and chronic bacteraemia: doxycycline 200 mg orally daily for 28 days combined with gentamicin 3 mg/kg/day intravenous for 14 days. 2006 Sep. 74(9):5003-13. Trench fever (also known as "five-day fever", "quintan fever" (Latin: febris quintana), and "urban trench fever"[1]) is a moderately serious disease transmitted by body lice. Survey of the seroprevalence of Bartonella quintana in homeless people. 53(3):e151-3. 2006 Mar;74(3):436-9. This article talks about the causes and cures for gingivitis. [QxMD MEDLINE Link]. This website also contains material copyrighted by 3rd parties. Raoult D, Roux V. The body louse as a vector of reemerging human diseases. [QxMD MEDLINE Link]. Lewis. Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D. Recommendations for treatment of human infections caused by Bartonella species. Clin Dermatol. Bartonella henselae survives after the storage period of red blood cell units: is it transmissible by transfusion? Pirard-Franchimont C, Quatresooz P, Pirard GE. An ickier outbreak: Trench fever spread by lice is found in Denver Bartonella quintana in cynomolgus monkey (Macaca fascicularis). 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. [9, 10, 1, 2, 4, 5, 11, 12] Typical periodic cycles of fever, chills, and sweats occurred at 5-day intervals, resulting in prolonged disability lasting 3 months or longer in young soldiers. When feeding on an infected human, the body louse ingests. Trench fever also known as the five-day fever, is a clinical syndrome caused by infection with Bartonella quintana; the condition was first described during World War 1 1.Contemporary Bartonella quintana disease, commonly referred to as urban trench fever, is typically found in homeless, alcoholic, and poor populations 2.The human body louse Pediculus humanus var corporis is the . [QxMD MEDLINE Link]. 72(6):1022-4. Since the 1990s, it has been recognised as a reemerging pathogen among impoverished and homeless populations so-called urban trench fever living in unsanitary conditions and crowded areas predisposing them to infestation with ectoparasites that may transmit the infection. Rare cases of Bartonella endocarditis and central nervous system (CNS) infection have been described in children.
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