Tench fever is a louse-borne disease caused by Bartonella quintana and observed originally in military populations during World Wars I and II. Symptoms are an acute, recurring febrile illness, occasionally with a rash. Diagnosis is by blood culture. Treatment is with a macrolide or doxycycline. 0.13 in 100,000 in Japan were affected with Trech Fever. Chloramphenicol is an alternative medication recommended under circumstances that render use of tetracycline derivates undesirable, such as severe liver malfunction, kidney deficiency, in children under nine years and in pregnant women. The drug is administered for seven to ten days.
Although recovery is usually complete in 1 to 2 mo and mortality is negligible, bacteremia may persist for months after clinical recovery, and prolonged (> 1 mo) doxycycline or macrolide treatment may be needed. Doxycycline 100 mg po bid for 28 days is given plus, if endocarditis is suspected, gentamicin 3 mg/kg/day IV for 2 wk. Researchers at Great Ormond Street Hospital have in the past claimed tackling a Trench fever with medicine before it is allowed to run its course, may slow recovery time, because the temperature can help to kill the bacteria causing the illness.