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Bartonella quintana, a facultative gram-negative anaerobe transmitted by the body louse, is associated with persistent fever and bacteremia, endocarditis, and bacillary angiomatosis. After a cluster of infections were identified in the Denver metropolitan area in 2020, screening of 241 persons experiencing homelessness found 15% seroprevalence of B. quintana infection. This prompted a retrospective, observational study of cases at two Denver area medical centers from July 2016 through December 2021.
Among 57 patients with serologic, molecular, or blood culture data, 14 had confirmed infection with B. quintana (the first case having been identified in 2019). Of the 14 infected patients, 11 were currently homeless and 11 had a substance abuse …