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Section 3. Summaries of Infectious Diseases
African Trypanosomiasis
(African Sleeping Sickness)
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: The rapidity and severity of clinical
manifestations vary with the infecting subspecies. With
Trypanosoma brucei gambiense (West African) infection, a cutaneous nodule
or chancre may appear at the site of parasite inoculation within
a few days of a bite by an infected tsetse fly. Systemic illness
is chronic, occurring months to years later, and is characterized
by intermittent fever, posterior cervical lymphadenopathy (Winterbottom
sign), and multiple nonspecific complaints, including malaise,
weight loss, arthralgia, rash, pruritus, and edema. If the central
nervous system (CNS) is involved, chronic meningoencephalitis
with behavioral changes, cachexia, headache, hallucinations,
delusions, and somnolence can occur. In contrast,
Trypanosoma brucei rhodesiense (East African) infection is an acute, generalized
illness that develops days to weeks after parasite inoculation,
with manifestations including high fever, cutaneous chancre,
myocarditis, hepatitis, anemia, thrombocytopenia, and laboratory
evidence of disseminated intravascular coagulopathy. Clinical
meningoencephalitis can develop as early as 3 weeks after onset
of the untreated systemic illness.
Trypanosoma brucei rhodesiense infection has a high fatality rate; without treatment, infected
patients usually die within days to months after clinical onset
of disease.
ETIOLOGY: The West African (Gambian) form of sleeping sickness
is caused
. . . [Go to Full Text]
Related text in Red Book:
- Drugs for Parasitic Infections
Red Book
2006: 790-820.
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