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Trench Fever

Disease Details

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Description: Trench fever is a louse-borne infectious disease caused by the bacterium Bartonella quintana, characterized by recurrent episodes of fever, headache, muscle pain, and rash.
Type: Trench fever is an infectious disease caused by the bacterium *Bartonella quintana*. It is not a genetically transmitted disease; rather, it is transmitted primarily through the bite of infected body lice.
Signs And Symptoms: The disease is classically a five-day fever of the relapsing type, rarely exhibiting a continuous course. The incubation period is relatively long, at about two weeks. The onset of symptoms is usually sudden, with high fever, severe headache, pain on moving the eyeballs, soreness of the muscles of the legs and back, and frequent hyperaesthesia of the shins. 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. The most constant symptom is pain in the legs. Trench fever episodes may involve loss of appetite, shin pain or tenderness, and spleen enlargement. Generally, one to five periodic episodes of fever occur, separated by four-to-six-day-long asymptomatic periods. Recovery takes a month or more. Lethal cases are rare, but in a few cases "the persistent fever might lead to heart failure". Aftereffects may include neurasthenia, cardiac disturbances, and myalgia.
Prognosis: Trench fever, caused by the bacterium Bartonella quintana, generally carries a good prognosis with appropriate antibiotic treatment. While the disease can result in prolonged symptoms such as recurrent fevers, headache, rash, and bone pain, most patients recover fully without long-term complications. However, immunocompromised individuals may experience more severe and persistent symptoms. If untreated, the condition can recur but is rarely fatal.
Onset: Onset: Trench fever typically has an abrupt onset with symptoms appearing suddenly, often including high fever, severe headache, leg pain (especially in the shins), and dizziness. The fever may last for several days and can recur in cycles.

Nan: Nan is not a relevant term or topic in the context of trench fever. If you need more specific information on trench fever, please provide more details or clarify your question.
Prevalence: The prevalence of trench fever varies depending on the region and population. It is relatively rare today but was more common during World War I and World War II. Cases still occur sporadically, often among homeless populations or in areas with poor sanitation, as the disease is transmitted by body lice. Accurate current prevalence data (nan) is not available.
Epidemiology: Trench fever is a vector-borne disease in which humans are primarily the main hosts. The vector through which the disease is typically transmitted is referred to as the human body louse Pediculus humanus humanus. 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. Although the disease is typically found in humans, the gram-negative bacterium which induces the disease has been seen in mammals such as dogs, cats, and macaques in small numbers.Being that the vector of the disease is a human body louse, it can be determined that the main risk factors for infection are mostly in relation to contracting body louse. Specifically, some risk factors include body louse infestation, overcrowded and unhygienic conditions, body hygiene, war, famine, malnutrition, alcoholism, homelessness, and intravenous drug abuse.The identified risk factors directly correlate with the subpopulations of identified infected persons throughout the duration of the known disease. Historically, trench fever was found in young male soldiers of World War I, whereas in the 21st century the disease mostly has a prevalence in middle-aged homeless men. This can be seen when looking at a 21st-century outbreak of the disease in Denver, Colorado, where researcher David McCormick and his colleagues came across the gram-negative bacterium in 15% of the 241 homeless persons who were tested. Another study done in Marseille, France found the bacterium in 5.4% of the 930 homeless individuals they tested.
Intractability: Trench fever, caused by the bacterium Bartonella quintana, is generally not considered intractable. It can be effectively treated with antibiotics such as doxycycline or erythromycin. However, if left untreated, it can lead to chronic or recurrent symptoms. Early diagnosis and appropriate treatment are key to managing the disease successfully.
Disease Severity: Trench fever is generally considered a mild to moderate illness. Symptoms can include high fever, severe headache, pain in the legs, particularly the shins, and occasionally a rash. The condition is rarely fatal but can cause significant discomfort and debilitation. Recurrent episodes can occur if not treated properly.
Healthcare Professionals: Disease Ontology ID - DOID:11101
Pathophysiology: Bartonella quintana is transmitted by contamination of a skin abrasion or louse-bite wound with the faeces of an infected body louse (Pediculus humanus corporis). There have also been reports of an infected louse bite passing on the infection.
Carrier Status: Carrier status for trench fever involves the human body louse (*Pediculus humanus corporis*), which is the primary vector transmitting the disease-causing bacterium *Bartonella quintana*. Humans can become carriers if they are infested with these lice, as the bacteria are transmitted through louse feces that come into contact with breaks in the skin.
Mechanism: Trench fever is a disease caused by the bacterium *Bartonella quintana*. It was first recognized during World War I, where it affected soldiers in the trenches, hence the name.

**Mechanism:**
1. **Transmission**: The primary vector for *Bartonella quintana* is the human body louse, *Pediculus humanus corporis*. When an infected louse feeds on a human host, *Bartonella quintana* is introduced through the louse's feces. Scratching the bite site facilitates the introduction of the bacteria into the bloodstream.
2. **Infection and Spread**: Once in the bloodstream, *Bartonella quintana* targets endothelial cells and can also infect erythrocytes (red blood cells). It has the capacity to evade the immune system, leading to a chronic bacteremia.

**Molecular Mechanisms:**
1. **Adhesion and Invasion**: *Bartonella quintana* expresses several outer membrane proteins, such as adhesins, that facilitate the bacterium's adherence to host cells. The bacterium can invade and replicate within endothelial cells. One such protein is the Bartonella adhesin A (BadA), which aids in endothelial cell attachment and invasion.
2. **Evasion of Immune Response**: *Bartonella quintana* can persist in the bloodstream due to its ability to evade the host immune response. It achieves this by varying its surface antigens to avoid detection and elimination by the host's immune system.
3. **Pathogenesis**: The infection of endothelial cells leads to the formation of angiogenic lesions and inflammation. The bacteria can induce the production of pro-inflammatory cytokines and chemokines, which contribute to the symptoms of trench fever, such as cyclical fever, headache, and pain in the shins (shinbone pain).

Understanding these mechanisms is critical for developing strategies to combat trench fever, particularly in endemic regions or among populations where body lice infestations are common.
Treatment: The treatment of trench fever can vary from case to case, as the human body has the ability to rid itself of the disease without medical intervention. Some patients will require treatment, and others will not. For those who do require treatment, the best treatment comes by way of doxycycline in combination with gentamicin. Chloramphenicol is an alternative medication recommended under circumstances that render the use of tetracycline derivates undesirable, such as severe liver disease, kidney dysfunction, in children under nine years and in pregnant women. The medication is administered for seven to ten days.
Compassionate Use Treatment: Trench fever is traditionally caused by the bacterium Bartonella quintana, which is typically transmitted by body lice. It's most commonly associated with World War I but still occurs in populations with poor hygiene and crowded living conditions.

For compassionate use treatment or off-label and experimental treatments of trench fever:

1. **Antibiotics**: The primary treatment involves antibiotics. Doxycycline, usually combined with gentamicin, is often used. Erythromycin is also an alternative.

2. **Azithromycin**: While not a standard treatment, azithromycin has been used off-label in certain cases, especially for patients who may be intolerant to doxycycline or erythromycin.

3. **Rifampin**: Occasionally used off-label, particularly in combination with other antibiotics, due to its efficacy against Bartonella species.

4. **Supportive Care**: Focused on managing symptoms such as fever, headache, and pain using NSAIDs and other supportive measures.

Always consult a healthcare professional for the most appropriate treatment options based on the individual case.
Lifestyle Recommendations: **Lifestyle Recommendations for Trench Fever:**

1. **Rest**: Ensure adequate rest to help the body recover.
2. **Hydration**: Drink plenty of fluids to stay hydrated.
3. **Hygiene**: Maintain good personal hygiene to prevent secondary infections.
4. **Clean Environment**: Keep living areas clean to reduce the risk of lice infestation, as the disease is transmitted by body lice.
5. **Avoid Crowded Areas**: Minimize time in crowded or unsanitary conditions where lice infestations are more likely.
6. **Treatment Adherence**: Follow any prescribed antibiotic treatment regimen as directed by a healthcare provider.
Medication: Trench fever, caused by the bacterium *Bartonella quintana*, is typically treated with antibiotics. The common medications include doxycycline and azithromycin. In some severe cases, the combination of doxycycline with rifampin may be used to ensure effective treatment. Always consult with a healthcare provider for appropriate diagnosis and treatment.
Repurposable Drugs: Trench fever is a bacterial infection caused by Bartonella quintana. While no specific repurposable drugs have been universally recognized for this condition, antibiotics such as doxycycline and azithromycin are commonly used to treat it.
Metabolites: For trench fever, specific metabolites directly linked to the disease are not well-documented. Trench fever is caused by the bacterium Bartonella quintana. The focus is usually on the detection and treatment of the bacterial infection rather than specific metabolic changes. Therefore, there isn't a comprehensive list of unique metabolites for trench fever in current medical literature.
Nutraceuticals: There is limited scientific evidence to support the efficacy of nutraceuticals in the treatment or prevention of trench fever. This bacterial infection, caused by Bartonella quintana, typically requires antibiotic treatment. For comprehensive management and treatment options, consulting a healthcare provider is recommended.
Peptides: Trench fever is caused by the bacterium Bartonella quintana. Peptides could potentially play a role in diagnostic or therapeutic applications, but there is limited information specifically targeting peptides for trench fever as of current knowledge. Further research may elucidate specific peptides that are effective in detection or treatment. There is no significant information correlating "nan" (commonly short for "nanometers" or "non-applicable" in different contexts) directly with trench fever.