African trypanosomiasis

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Background

  • AKA sleeping sickness
  • Caused by Trypanosoma brucei gambiense¬†and Trypanosoma brucei rhodesiense
  • Transmitted by the tsetse fly

Clinical Features

  • initial features
    • Localized inflammatory reaction after tsetse fly bite
    • Painless chancre 2-3 days later, lasts 2-3 weeks
  • Systemic disease
    • Intermittent Fever
    • Malaise, wasting
  • CNS involvement
  • Other complications
  • Winterbottom's sign: posterior cervical LAD (Gambiense)

Differential Diagnosis

Travel Related Skin Conditions

Papules

Sub Q Swelling and Nodules

Ulcers

Linear and Migratory Lesions

Evaluation

  • Blood smear to identify parasite
  • Parasites can also be found in lymph nodes, chancres, bone marrow, or CSF

Management

  • Consult ID early!
  • No CNS involvement
  • CNS involvement
    • Melarsoprol, eflornithine, or a combination of nifurtimox and eflornithine

Disposition

See Also

External Links

References