Difference between revisions of "African trypanosomiasis"
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==Background== | ==Background== | ||
| − | * | + | *AKA sleeping sickness |
| + | *Caused by ''Trypanosoma brucei gambiense'' and ''Trypanosoma brucei rhodesiense'' | ||
| + | *Transmitted by the tsetse fly | ||
==Clinical Features== | ==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 | ||
| + | **Behavioral changes | ||
| + | **[[Encephalitis]] | ||
| + | **[[Coma]] | ||
| + | **Death | ||
| + | *Other complications | ||
| + | **Hemolysis, [[anemia]] | ||
| + | **Pancarditis | ||
| + | **[[Meningoencephalitis]] | ||
*Winterbottom's sign: posterior cervical LAD (Gambiense) | *Winterbottom's sign: posterior cervical LAD (Gambiense) | ||
| Line 8: | Line 25: | ||
{{Travel Skin Conditions DDX}} | {{Travel Skin Conditions DDX}} | ||
| − | == | + | ==Evaluation== |
| + | *Blood smear to identify parasite | ||
| + | *Parasites can also be found in lymph nodes, chancres, bone marrow, or CSF | ||
==Management== | ==Management== | ||
| + | *Consult ID early! | ||
| + | *No CNS involvement | ||
| + | **[[Pentamidine]] or suramin | ||
| + | *CNS involvement | ||
| + | **Melarsoprol, eflornithine, or a combination of nifurtimox and eflornithine | ||
==Disposition== | ==Disposition== | ||
| Line 20: | Line 44: | ||
==External Links== | ==External Links== | ||
| − | == | + | ==References== |
<references/> | <references/> | ||
[[Category:ID]] | [[Category:ID]] | ||
[[Category:Tropical Medicine]] | [[Category:Tropical Medicine]] | ||
Revision as of 18:13, 27 March 2017
Contents
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
- Behavioral changes
- Encephalitis
- Coma
- Death
- Other complications
- Hemolysis, anemia
- Pancarditis
- Meningoencephalitis
- Winterbottom's sign: posterior cervical LAD (Gambiense)
Differential Diagnosis
- Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
- Sub Q Swelling and Nodules
- Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
- Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis
See also domestic U.S. ectoparasites
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
- Pentamidine or suramin
- CNS involvement
- Melarsoprol, eflornithine, or a combination of nifurtimox and eflornithine