About Bartonella quintana

Key points

  • Bartonella quintana is one of several bacteria that cause the disease bartonellosis.
  • People get B. quintana bacteria from human body lice. Rarely, B. quintana can spread through organ transplant.
  • Bartonella quintana infection occurs worldwide, most commonly among people living in crowded conditions with limited access to hygienic services.
Body louse on human skin.

Overview

Bartonella quintana bacteria are spread to people by human body lice. Body lice spread from person to person by close physical contact or through shared clothing or bedding.

Infection with B. quintana is most commonly associated with body louse infestations in areas of high population density and poor sanitation. There have been rare reports of B. quintana infection in people with no documented exposure to body lice. Rare cases of B. quintana bartonellosis have been reported following organ transplantation.

Bartonella quintana infection occurs worldwide.

The history of B. quintana

During the first World War, infection with B. quintana was referred to as "trench fever" due to the many cases among soldiers who lived in crowded trenches under poor hygienic conditions.

Signs and symptoms

People infected with B. quintana might have the following symptoms:

  • Fever (may occur once or repeatedly)
  • Headache
  • Bone pain (mainly in the shins, neck, and back)
  • As with other Bartonella species, B. quintana can sometimes cause infection of the heart valves, called endocarditis. In many cases, blood cultures might be negative (culture-negative endocarditis), which can make the diagnosis more challenging.
  • Lesions called "bacillary angiomatosis"
    • Bacillary angiomatosis primarily affects people with weakened immune systems, such as those with advanced HIV infection.
    • Bacillary angiomatosis can present as vascular lesions in the skin, under the skin, in bone, or in other organs.
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Bacillary angiomatosis on fingers and toes.
Bacillary angiomatosis lesions usually appear as dark purplish nodules in or under the skin. Used with permission of New England Journal of Medicine.

For healthcare providers

Clinical Overview of Bartonella quintana discusses testing, diagnosis, and treatment.

People at risk

People with current or past body louse infestations and people experiencing homelessness have a higher risk of infection with B. quintana.

Crowded living conditions and limited access to hygienic services, such as showers and laundry facilities, can contribute to the spread of B. quintana.

Treatment of body lice

You can treat body lice infestations by improving personal hygiene. Sometimes a medicine is prescribed to kill body lice.

Prevention

To prevent bartonellosis caused by B. quintana:

  • Do not share clothing, beds, bedding, or towels used by a person who might have body lice.
  • Improve personal hygiene. Access to regular showers and laundry services can prevent B. quintana infection among people living in congregate shelters or who lack access to housing.
  • When washing clothes or bedding that may be infested with body lice, use hot water above 55 degrees Celsius (130 degrees Fahrenheit) and dry on high heat to kill lice and their eggs.

Treatment

Infection with B. quintana requires antibiotic treatment.

Several antibiotics can treat this infection. Healthcare providers will often prescribe more than one type of antibiotic to make sure the infection is gone.

If you are diagnosed with B. quintana infection, your healthcare provider may consult an infectious disease specialist to help choose the best treatment.

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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)