A 40-year-old homeless man living in unsanitary conditions presents with recurrent episodes of high fever lasting about 5 days separated by afebrile intervals, along with headache and bone pain. Blood cultures after prolonged incubation grow gram-negative bacilli. Body lice are found on his clothing. The causative agent is:
- A Borrelia recurrentis
- B Bartonella henselae
- C Bartonella quintana ✓
- D Rickettsia prowazekii
Correct answer: C. Bartonella quintana
Explanation
Bartonella quintana causes trench fever, historically affecting soldiers in World War I and now re-emerging as urban trench fever among homeless, louse-infested populations. It produces quintan fever, classically recurring every 5 days, with bone pain, and causes chronic bacteraemia. Transmission is by the body louse. Borrelia recurrentis also uses the body louse but is a spirochaete causing shorter relapsing cycles. B. henselae is cat-associated and flea-borne.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.