Trench fever is a bacterial infection which is caused by the Bartonella quintana. 

In World War I, trench fever is a very serious issue because it directly affects trenches of soldiers, and these bacteria are transmitted through the louse body which work as vector for infection.  

The bacteria enter through a bite of infected body lice which live on human blood. 

This type of illness-infection is present in all continents but in Antarctica it is not observed. 

The situations like war, malnutrition, poor hygiene, and alcoholism increase the chance of infection. 

The bond between endothelial vascular proliferation and destructive valvular lesions of B quintana endocarditis is still unclear. 

B quintana enters in the human body, attacks on erythrocytes and endothelial cells where it is protected by host’s humoral immune response. 

Homeless individuals with chronic B quintana bacteria found to overproduce interleukin-10. 

B quintana bacteria can be intermittent as they suck blood in arthropods are effective transmitters of the infection. The entry of louse feces and arthropod bites into the body through skin breaks. 

The bacterium circulates among human populations due to its lack of a significant environmental reservoir. 

B quintana infection self-resolves in immunocompetent hosts unless endocarditis occurs while in immunocompromised hosts it becomes more severe and potentially leads to death. 

B quintana endocarditis in alcoholic males with no homes has a death rate of 12%. 

Trench fever is seen in adults and cases occurs in young and older individuals. 

Assessment of headache and skin rash 

Assessment of muscle ache and back pain 

Cardiovascular and Respiratory Examination 

Patients suffering with trench fever may experience muscle ache and back pain in a critical manner.   

Patients initially experience mild symptoms but over several days they worsen more.  

e.g. Headache 

Physicians should immediately prescribe antibiotic therapy once the patient is diagnosed. The therapy should be given a minimum of 5 to 7 days. 

Patients should take proper rest and maintain hydration level to get relief from pain and help them recover quickly.  

Appointments with medical physicians and preventing recurrence of disorder is an ongoing life-long effort. 

Infectious Disease

Daily hygiene practices such as bathing, sanitization, and cleaning are important in reducing the risk of body lice and preventing trench fever.  

Education should be given to individuals about cautious with activities that could cause this type of bacterial infection. 

Patient should stay in adequate conditions with good ventilation, air quality and a clean environment. 

Infectious Disease

Doxycycline: It is absorbed completely and excreted in urine as a biologically active metabolite in high concentrations. 

Gentamicin: The synthesis of bacterial proteins is damages which binds with the 30S and 50S ribosomal subunits. 

Ceftriaxone: It has lower efficacy against gram-positive organisms and higher efficacy against resistant organisms. 

These antibiotic drugs are widely used for treatment of trench fever as first choice options and sometimes as alternatives as per the condition of patient.  

The standard dose for these antibiotic drugs is 100 mg to 500 mg daily. A dose is taken orally, as suggested by the physician for a course of 5 to 7 days. 

Infectious Disease

Surgical biopsy is a procedure for determining the exact diagnosis of B quintana endocarditis and lymphadenitis. 

Microbiologic studies may not suggest good clinical efficacy due to B quintana’s clinical response. 

Infectious Disease

In the initial diagnosis phase, the physician assesses symptoms related to trench fever which is followed by diagnostic tests, including blood cultures, and polymerase chain reaction to confirm the diagnosis of B quintana.   

In the supportive care and preventive measure phase all necessary steps should be taken by physicians to enhance the quality of life of the patient. 

Regular follow-up visits with medical physicians are required to check the improvement of patients and newly observed complaints.