Difference between revisions of "African trypanosomiasis"

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(Background)
 
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==Background==
 
==Background==
*Tsetse fly
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[[File:AfrTryp LifeCycle.png|thumb|The life cycle of ''Trypanosoma brucei''.]]
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*AKA sleeping sickness
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*Caused by ''Trypanosoma brucei gambiense'' and ''Trypanosoma brucei rhodesiense''
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*Transmitted by the tsetse fly
  
 
==Clinical Features==
 
==Clinical Features==
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[[File:PMC5373517 pntd.0005324.g001.png|thumb|Cervical LAD in African trypanosomiasis]]
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[[File:AcuteSleepingSickness.jpg|thumb|Typical fine-spotted pink rash of acute African trypanosomiasis on the skin of the abdomen (”trypanid rash”).]]
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[[File:SSHemorragicRash.jpg|thumb|Petechiae of leg in a person infected with T. b. rhodesiense]]
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*Initial features
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**Localized inflammatory reaction after tsetse fly bite
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**Painless chancre 2-3 days later, lasts 2-3 weeks
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*Systemic disease
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**Intermittent [[Fever]]
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**Malaise, wasting
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*CNS involvement
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**Behavioral changes
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**[[Encephalitis]]
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**[[Coma]]
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**Death
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*Other complications
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**Hemolysis, [[anemia]]
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**Pancarditis
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**[[Meningoencephalitis]]
 
*Winterbottom's sign: posterior cervical LAD (Gambiense)
 
*Winterbottom's sign: posterior cervical LAD (Gambiense)
  
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{{Travel Skin Conditions DDX}}
 
{{Travel Skin Conditions DDX}}
  
==Diagnosis==
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==Evaluation==
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[[File:PMC3989118 gr3.png|thumb|MRI of patient with African trypanosomiasis demonstrating extensive white matter involvement.]]
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*Blood smear to identify parasite
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*Parasites can also be found in lymph nodes, chancres, bone marrow, or CSF
  
 
==Management==
 
==Management==
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*Consult ID early!
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*No CNS involvement
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**[[Pentamidine]] or suramin
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*CNS involvement
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**Melarsoprol, eflornithine, or a combination of nifurtimox and eflornithine
  
 
==Disposition==
 
==Disposition==

Latest revision as of 12:59, 12 December 2020

Background

The life cycle of Trypanosoma brucei.
  • AKA sleeping sickness
  • Caused by Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense
  • Transmitted by the tsetse fly

Clinical Features

Cervical LAD in African trypanosomiasis
Typical fine-spotted pink rash of acute African trypanosomiasis on the skin of the abdomen (”trypanid rash”).
Petechiae of leg in a person infected with T. b. rhodesiense
  • 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

See also domestic U.S. ectoparasites

Evaluation

MRI of patient with African trypanosomiasis demonstrating extensive white matter involvement.
  • 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