African trypanosomiasis


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


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


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


See Also

External Links