African trypanosomiasis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
[[File:PMC5373517 pntd.0005324.g001.png|thumb|Cervical LAD in African trypanosomiasis]] | [[File:PMC5373517 pntd.0005324.g001.png|thumb|Cervical LAD in African trypanosomiasis]] | ||
[[File:AcuteSleepingSickness.jpg|thumb|Typical fine-spotted pink rash of acute African trypanosomiasis on the skin of the abdomen (”trypanid rash”).]] | |||
*Initial features | *Initial features | ||
**Localized inflammatory reaction after tsetse fly bite | **Localized inflammatory reaction after tsetse fly bite | ||
Revision as of 12:52, 12 December 2020
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)
- Macular
- 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