Shin bone fever, often referred to as trench fever, is a disease that primarily causes fever and leg pain. This condition is transmitted by body lice and was first identified during World War I, affecting over a million individuals in Russia and across European battlefields. It reemerged as a significant concern during World War II and continues to be prevalent in regions such as Mexico, Africa, Eastern Europe, and other locations. In urban settings, trench fever is commonly found among homeless populations. Documented outbreaks have occurred in cities like Seattle, Baltimore (particularly among injection-drug users), Marseilles in France, and Burundi.The bacterium responsible for trench fever is Bartonella quintana, also known as Rochalimaea quintana. This organism multiplies within the gut of body lice. Humans can become infected by scratching louse feces into broken skin or the whites of the eyes. The disease typically manifests as a five-day fever, with sudden onset symptoms including high fever, intense headaches, leg pain, and a transient rash. Recovery may take over a month, and relapses are frequent. In urban cases, especially among the homeless, trench fever can present with vague symptoms or even be asymptomatic, as noted in a study published in the New England Journal of Medicine (1999).B. quintana is also linked to bacillary angiomatosis in individuals with compromised immune systems and can cause infections of the heart and major blood vessels, leading to bloodstream infections. Trench fever is known by various other names, including Wolhynia fever, quintan fever, five-day fever, Meuse fever, His' disease, and His-Werner disease.
