Febris quintana A79.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Five-day fever; quintan fever; trench fever; Trench fever; Volhynia fever; Wolhynia fever

Definition
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Bar tonnelloses transmitted by clothes lice and crabs.

Pathogen
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Bartonella quintana (see Bartonellose below).

Clinical features
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  • Incubation period up to 2 months. Fever rises approximately every 5 days with chills and sweating. Number of fever attacks: 3-12. paraesthetic symptoms: shin pain.
  • Skin lesions: volatile macular, possibly hemorrhagic exanthema. Also symptoms of pediculosis corporis.

Diagnosis
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Serologically (Weil-Felix reaction, CBR, IFT).

Differential diagnosis
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External therapy
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Blande, symptomatic therapy, e.g. with Lotio alba or Lotio Cordes

Internal therapy
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  • Tetracyclines (e.g. Achromycin), initial 25 mg/kg bw/day p.o. to 3-4 ED. Alternatively: Doxycycline (e.g. Doxy Wolff) 200 mg/day p.o. or i.v., therapy duration 10-12 days.
  • Equally effective are gyrase inhibitors such as Ofloxacin (e.g. Tavanic) 2 times/day 200-400 mg p.o. or i.v. and Rifampicin (e.g. Rifa) 450-600 mg/day p.o. (depending on KG).

Note(s)
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The disease takes its name from Volhynia, an area on the eastern front of the two world wars, where it was first observed and at that time was also called trench fever.

Literature
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  1. Chian CA et al (2002) Skin manifestations of Bartonella infections. Int J Dermatol 41: 461-466
  2. Fournier PE et al (2002) Human pathogens in body and head lice. Emerg Infect Dis 8: 1515-1518
  3. Minnick MF et al (2003) Five-member gene family of Bartonella quintana. Infect Immune 71: 814-821
  4. Ohl ME et al (2000) Bartonella quintana and urban trench fever. Clin Infect Dis 31: 131-135
  5. Raoult D et al (2001) Infections in the homeless. Lancet Infect Dis 1: 77-84
  6. Tea A et al (2003) Occurrence of Bartonella henselae and Bartonella quintana in a healthy Greek population. At J Trop Med Hyg 68: 554-556

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020