trench fever

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Trench Fever



Trench fever is a bacterial infection that causes repeated cycles of high fever.


The term trench fever refers to the crowded conditions in which troops fought in during World War I and World War II. Because the causative bacteria are passed among humans through contact with body lice, overcrowding, and conditions which interfere with good hygiene (including regular washing of clothing) soldiers were predispose to this disease. Currently, homeless people in the United States are sometimes diagnosed with this illness. The bacteria are sometimes passed through the bite of an infected tick. This can cause the illness in people who participate in outdoor activity and encounter ticks in that particular area.

Causes and symptoms

Two different bacteria can cause trench fever: Bartonella quintana and Bartonella henselae. B. quintana is carried by body lice; B. henselae is carried by ticks.
Infection with B. quintana occurs when an infected louse defecates while feeding on a human. When the person scratches, the feces (which are full of bacteria) are rubbed into the tiny wound. Infection with B. henselae occurs when an infected tick bites a human, passing the bacteria along through the tiny bite wound.
Symptoms of trench fever begin about 2 weeks to a month after exposure to the bacteria. Sudden fever, loss of energy, dizziness, headache, weight loss, skin rash, severe muscle and bone pain can occur. Pain is particularly severe in the shins, leading to the nickname "shin bone fever." The fever can reach 105°F (40.5°C) and stays high for five to six days at a time. The temperature then drops, and stays down for several days, usually recurring in five- to six-day cycles. An individual may experience as many as eight cycles of fever with the illness.


Diagnosis is usually made on the basis of the patient's symptoms, and on knowledge of the conditions in which the patient lives. A blood sample can be drawn and bacteria in the sample are allowed to grow. Identification is made by looking at the number of bacteria that may be present on a glass slide seen under the lens of a microscope. However, this technique can take up to four weeks, because this type of bacterium grows very slowly. By this time, the practitioner has often decided to treat the patient anyway.


Erythromycin and azithromycin are both used to treat trench fever. Four weeks of treatment are usually necessary. Inadequate treatment often results in a relapse. In fact, relapses have been reported to occur as long as 10 years after the first episode.


Prognosis for patients with trench fever is excellent. Recovery may take a couple of months. Without treatment, there is always a risk of recurrence, even years after the original illness.


Prevention involves good hygiene and decent living conditions. When this is impossible, insecticide dusting powders are available to apply to clothing. Avoidance of areas known to harbor ticks or the use of insect repellents is necessary to avoid the type of infection passed by ticks.



Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311.

trench fever

a louseborne rickettsial disease due to Rochalimaea quintana, transmitted by the human body louse, Pediculus humanus; symptoms include febrile paroxysms, leg pains, chills, sweating, rash, splenomegaly, and a tendency to relapse. Called also His's or His-Werner disease.

trench fe·ver

an uncommon rickettsial fever caused by Bartonella quintana and transmitted by the louse Pediculus humanus, first appearing as an epidemic during the trench warfare of World War I; characterized by the sudden onset of chills and fever, myalgia (especially of the back and legs), headache, and general malaise that typically lasts 5 days but may recur.

trench fever

An acute infectious disease characterized by chills and fever, caused by the bacterium Bartonella quintana and transmitted by body lice.
A rickettsia-like disease caused by Bartonella quintana (formerly Rochalimaea quintana, Rickettsia quintana) transmitted by the faeces of the body louse—Pediculus humanus—under crowded conditions of poor hygiene, first recognised in the trenches of World War I, which recurred in World War II. It occurs endemically in Mexico, northern Africa, eastern Europe, and elsewhere
Management Tetracycline, broad-spectrum antibiotics, eradicate lice

trench fever

A rickettsia-like disease caused by Bartonella quintana transmitted by the feces of the body louse–Pediculus humanus under crowded conditions of poor hygiene, seen in endemic form in developing nations  Clinical Abrupt onset of paroxysmal fever, asthenia, chills, vertigo, headache, backache, characteristic shin pain, truncal rash, transient maculopapules and moderate leukocytosis; febrile relapse Treatment Tetracycline, broad-spectrum antibiotics, eradicate. See Saddleback curve.

trench fe·ver

(trench fē'vĕr)
An uncommon rickettsial fever caused by Bartonella quintana and transmitted by the louse Pediculus humanus; first appeared as an epidemic during trench warfare in World War I (1914-1918); characterized by the sudden onset of chills and fever, myalgia (especially of the back and legs), headache, and general malaise that typically lasts 5 days but may recur.

trench fever

A louse-borne infection caused by Rickettsia quintana that was prevalent in World War I but is now rare. It features headache, fever, severe pain in the legs and back, and a tendency to relapse at intervals of 5 or 6 days.