Bartonella quintana infection (historically called 'trench fever') is a vector-borne disease primarily transmitted by the human body louse. It has been recognised ...SkiptomaincontentGlobalNavigationOthersites:ECDCEuropeanAntibioticAwarenessDayESCAIDE-ScientificconferenceEurosurveillancejournalEVIP-VaccinationportalHomeAlltopics:AtoZBartonellaquintanainfection/trenchfeverFactsBartonellaquintanainfection/trenchfeverFactsFactsaboutBartonellaquintanainfection(‘trenchfever’)FactsheetTwitterFacebookLinkedInMailDisclaimer:Theinformationcontainedinthisfactsheetisintendedforthepurposeofgeneralinformationandshouldnotsubstituteindividualexpertadviceandjudgementofhealthcareprofessionals.Introduction Bartonellaquintanainfection(historicallycalled‘trenchfever’)isavector-bornediseaseprimarilytransmittedbythehumanbodylousePediculushumanushumanus.Theinfectionisassociatedwithawidevarietyofclinicalconditions,includingchronicbacteraemia,endocarditis,lymphadenopathyandbacillaryangiomatosis.Sincethe1990s,ithasbeenrecognisedasareemergingpathogenamongimpoverishedandhomelesspopulations—so-called‘urbantrenchfever’—livinginunsanitaryconditionsandcrowdedareaspredisposingthemtoinfestationwithectoparasitesthatmaytransmittheinfection.Primarypreventionoftrenchfeverreliesonmeasuresforavoidinginfestationwithbodylice.Thepathogen  B.quintanaisslow-growingGram-negativebacteriumwithshortrodsmorphology(0.3to0.5μmwideand1.0to1.7μmlong).B.quintanahasacircularchromosome(≈1.6Mb)recognisedasagenomicderivativeofBartonellahenselae,thecausativeagentofcatscratchdisease[1].Clinicalfeaturesandsequelae Theincubationperiodisusuallybetween15and25daysbuthasbeenreportedasshorter,uptosixdays,underexperimentalconditions[2].ClinicalmanifestationsofB.quintanainfectionincludetheclassicalrecurrentfever‘trenchfever’,chronicbacteraemia,endocarditisand,amongimmunocompromisedindividuals,bacillaryangiomatosis.Lymphadenopathyandocularcomplicationsareoccasionallyreported.Trenchfeverorquintanafever(5-dayfever)isarecurrentfeveramongn