Difference between revisions of "African trypanosomiasis"

(Text replacement - "==Diagnosis==" to "==Evaluation==")
 
Line 1: Line 1:
 
==Background==
 
==Background==
*Tsetse fly
+
*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 9: Line 26:
  
 
==Evaluation==
 
==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==

Latest revision as of 18:13, 27 March 2017

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
  • Other complications
  • Winterbottom's sign: posterior cervical LAD (Gambiense)

Differential Diagnosis

Travel-related skin conditions

Papules

Sub Q Swelling and Nodules

Ulcers

Linear and Migratory Lesions

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
  • CNS involvement
    • Melarsoprol, eflornithine, or a combination of nifurtimox and eflornithine

Disposition

See Also

External Links

References