Febris quintana A79.0

Five-day fever (Febris quintana =Wolhynian fever) is a rare bartonellosis transmitted by B. quintana. It is transmitted by lice and was originally seen in soldiers of World War 1 and 2. Fifth-day fever occurs endemically in Mexico, Tunisia, Eritrea, Poland, and the CIS countries, and has also been found in homeless people in the United States.

Incubation period up to 2 months. Fevers repeating about every 5 days with chills and sweats. Number of fever attacks: 3-12. paraesthetic symptoms: shin pain.

Skin lesions: Volatile macular, possibly haemorrhagic exanthema. Also symptoms of pediculosis corporis.

Tetracycline (e.g. achromycin), initially 25 mg/kg bw/day p.o. on 3-4 doses. Alternatively, doxycycline (e.g. Doxy Wolff) 200 mg/day p.o. or i.v., duration of therapy 10-12 days.

Equally effective are gyrase inhibitors such as ofloxacin (e.g. Tavanic) 2 times/day 200-400 mg p.o. or i.v. and rifampicin (e.g. Rifa) 450-600 mg/day p.o. (depending on the bw).

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