Five Days Fever

(Wolhynisches fever, shinbone fever, Quintanafieber)

The five-day fever is caused by Bartonella quintana and transmitted by lice disease that was initially observed in soldiers of the 1st and 2nd World War. It is an acute, recurrent febrile illness accompanied occasionally with a skin rash. The diagnosis is made by blood culture. For treatment to macrolides or doxycycline are.

(See also overview of infections caused by Bartonella.)

The five-day fever is caused by Bartonella quintana and transmitted by lice disease that was initially observed in soldiers of the 1st and 2nd World War. It is an acute, recurrent febrile illness accompanied occasionally with a skin rash. The diagnosis is made by blood culture. For treatment to macrolides or doxycycline are. (See also overview of infections caused by Bartonella.) Humans are the only known reservoir of Bartonella infection. B. quintana is transmitted to man by lice feces of infected is rubbed into the skin or eroded conjunctiva. Five days fever occurs in Mexico, Tunisia, Eritrea, Poland and the CIS countries endemic and is now also among the homeless in the US back in front. Symptoms and complaints After a 14- to 30-day incubation period, it suddenly comes to five-day fever, weakness, dizziness, headache (pain behind the eyes), conjunctival redness and severe back and leg pain (shin bone). The fever can be up to 40.5 ° C rise and last for 5-6 days. In about half the cases, the fever occurs 1 to 8 times in 5 to 6-day intervals again. There is a transient macular or papular rash, and occasionally hepatomegaly and splenomegaly. Endocarditis may complicate some cases. Recurrences are common and occurred after the initial infection up to 10 years. Diagnostic blood cultures serological tests and PCR to five-day fever should be considered in people who live in conditions in which occur frequently lice. The differential diagnosis should be considered a leptospirosis, typhus, relapsing fever and malaria. The causative agent is identified by blood cultures, although growth may require a one- to four-week incubation. The disease is during the primary infection, while the recurrence while in the asymptomatic stages between the recurrences and in patients with endocarditis by persistent bacteremia. Serological tests are available and can provide support for the diagnosis. High titers of IgG antibodies should have testing for endocarditis result. It can be made from blood or tissue samples PCR tests. Therapy doxycycline, a macrolide or ceftriaxone Although it usually occurs within 1-2 months to complete remission and not there is a mortality bacteremia may persist for months after clinical recovery and a prolonged (> 1 month) therapy with doxycycline or a macrolide required do. The patient is doxycycline 100 mg po 2 times / day for 4 to 6 weeks plus administered when a endocarditis is believed gentamicin 3 mg / kg / day i.v. for the first 2 weeks. Body lice must be brought under control. Patients with chronic bacteremia should be monitored for signs of endocarditis out.

Health Life Media Team

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