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| {{SI}} | | {{Trench fever}} |
| | '''For patient information, click [[Trench fever (patient information)|here]]''' |
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| {{CMG}} | | {{CMG}} |
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| | {{SK}} Wolhynia fever; shin bone fever; quintan fever; five-day fever; Meuse fever; His disease; His-Werner disease |
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| | ==[[Trench fever overview|Overview]]== |
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| {{SK}} Wolhynia fever; shin bone fever; quintan fever; five-day fever; Meuse fever; His disease and His-Werner disease
| | ==[[Trench fever historical perspective|Historical Perspective]]== |
| ==Overview== | |
| '''Trench Fever''' is a moderately serious [[disease]], transmitted by [[body louse|body lice]].
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| ==Historical Perspective==
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| It infected the armies in Flanders, France, Poland, Galicia, Italy, Slonika, Macedonia, Mesopotamia, and Egypt in World War I<ref name="Justina">{{cite book|title=Silent Enemies: The Story of the Diseases of War and Their Control|author=Justina Hamilton Hill|date=1942|publisher=G. P. Putnam's Sons}}</ref><ref name="Hagan">{{cite book|title=Hagan and Bruner's Microbiology and Infectious Diseases of Domestic Animals|author=Francis Timoney, William Arthur Hagan|publisher=Cornell University Press|date=1973}}</ref> (including J.R.R. Tolkien<ref name="Tolkien">{{cite book|title=Tolkien and the Great War: The Threshold of Middle-earth|author=John Garth|publisher=HarperCollins Publishers|date=2003}}</ref>) and the German army in Russia during World War II.<ref name="Hagan"/> From 1915-1918 between one-fifth and one-third of all British troops reported ill were caused by Trench Fever while about one-fifth of ill German and Austrian troops had the disease.<ref name="Justina"/> The disease persists among the homeless.<ref>Milonakis, Eleftherios, and Michael A. Forgione. "Trench Fever." EMedicine. 26 June 2006. 11 June 2007 <http://www.emedicine.com/med/topic2303.htm>.</ref> Outbreaks have been documented, for example, in Seattle, Washington and Baltimore, Maryland in the United States among injection drug users and in Marseille, France and Burundi.
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| == Pathohysiology==
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| ''Rickettsia quintana'' is transmitted by the by contamination of a skin abrasion or of a louse-bite wound with the faeces of an infected [[body louse]] (''Pediculus humanus corporis''), there has also been reports of an infected louse bite passing on the infection.<ref name="Hagan"/><ref name="Tropical">{{cite book|title=The Diagnostics and treatment of tropical diseases|author=Edward Rhodes Stitt|publisher=P. Blakiston's Son & Co.|date=1922}}</ref>
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| ==Causes==
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| The disease is caused by the organism ''Rickettsia quintana'', found in the stomach walls of the [[body louse]].<ref name="Hagan"/> Rickettsia is closely related to the more dangerous microbes of [[Rocky Mountain spotted fever]] and [[typhus]]<ref name="Justina"/>
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| == History and Symptoms ==
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| The disease is classically a five-day [[fever]] of the relapsing type, rarely with a continuous course instead. [[Latent period]] is relatively long (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 frequently 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.<ref name="Tropical"/> The most constant symptom is pain in the legs.<ref name="Hagan"/> Recovery takes a month or more. Lethal cases are rare, but in a few cases "the persistent fever might lead to heart failure".<ref name="Tropical"/><ref name="Tolkien"/> After effects may include neurasthenia, cardiac disturbances and myalgia.<ref name="Tropical"/>
| | ==[[Trench fever pathophysiology|Pathophysiology]]== |
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| ==Laboratory Findings== | | ==[[Trench fever causes|Causes]]== |
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| [[Serological]] testing (e.g., the [[Weil-Felix test]]) is typically used to obtain a definitive [[diagnosis]]. Most serological tests would succeed only after a certain period of time past the symptom onset (usually a week). [[Differential diagnosis]] list includes [[typhus]], [[Ehrlichiosis]], [[leptospirosis]], [[Lyme disease]] and [[virus]]-caused [[exanthem]]a ([[measles]], [[rubella]]). | | ==[[Trench fever differential diagnosis|Differentiating Trench fever from other Diseases]]== |
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| ==Medical Therapy== | | ==[[Trench fever epidemiology and demographics|Epidemiology and Demographics]]== |
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| [[Tetracycline]]-group antibiotics ([[doxycycline]], [[tetracycline]]) are commonly used. [[Chloramphenicol]] is an alternative medication recommended under circumstances that render tetracycline derivates usage undesirable (such as severe [[liver]] malfunction, [[kidney]] deficiency, in children under nine years and pregnant women). The drug is administered for seven to ten days. | | ==[[Trench fever natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| | ==Diagnosis== |
| | [[Trench fever history and symptoms| History and Symptoms]] | [[Trench fever physical examination | Physical Examination]] | [[Trench fever laboratory findings|Laboratory Findings]] | [[Trench fever electrocardiogram|Electrocardiogram]] | [[Trench fever other diagnostic studies|Other Diagnostic Studies]] |
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| The treatment for bacillary angiomatosis is [[erythromycin]] given for three to four months.<ref>{{cite journal | author=Beghari S, Rolain J-M, Grau GE, ''et al.'' | title=Antiangiogenic effect of erythromycin: an in vitro model of ''Bartonella quintana'' infection | journal=J Infect Dis | year=2006 | volume=193 | issue=3 | pages=380–6 }}</ref>
| | ==Treatment== |
| | [[Trench fever medical therapy|Medical Therapy]] | [[Trench fever primary prevention|Primary Prevention]] | [[Trench fever cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Trench fever future or investigational therapies|Future or Investigational Therapies]] |
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| == References == | | ==Case Studies== |
| <references/>
| | [[Trench fever case study one|Case #1]] |
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| {{Bacterial diseases}} | | {{Bacterial diseases}} |
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| [[Category:Bacterial diseases]] | | [[Category:Bacterial diseases]] |
| [[Category:Infectious disease]]
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| [[Category:Disease]] | | [[Category:Disease]] |