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During the past few months it has been my good fortune to observe several hundred cases of this extremely prevalent, carefully studied, but yet undetermined infection, known as trench fever. The name is really a misnomer. At first it was considered a result of trench life, and traumatic periostitis of the tibiae was thought to be the underlying pathologic process. Today we know that it develops in troops that have not experienced trench work; indeed, it develops sporadically in individuals who have only occasionally visited training camps and convalescent hospitals.
This so-called trench fever is a distinct clinical entity, and may be defined as an acute infectious disease of unknown etiology and self-limited course, characterized clinically by cyclic febrile attacks, intense headache and backache, and pains over the tibiae which are particularly severe at night.
—The specific cause has not been determined. Diplococci have occasionally been found in blood
MANDEL M. TRENCH FEVER: PRELIMINARY REPORT. JAMA. 1917;LXIX(9):725–726. doi:10.1001/jama.1917.25910360005013
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