Cases reported "Trypanosomiasis, African"

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1/37. Rhodesian trypanosomiasis in a splenectomized patient.

    We report the first apparent case of a splenectomized individual who developed severe trypanosomiasis with central nervous system involvement. The patient was a 41-year-old man who participated in an east African safari. Upon his return to the united states, the patient presented with an infection with trypanosoma brucei rhodesiense that was treated successfully with suramin and melarsoprol. The onset of symptoms, laboratory studies, and disease progression did not differ from previously reported cases in the literature. The role of the spleen in trypanosomiasis is not well understood and the few reports available describe only animal models. This report suggests that asplenia had no apparent effect on the onset of symptoms and overall severity of illness. Further studies are necessary to ultimately define the role of the spleen in trypanosomiasis. ( info)

2/37. African trypanosomiasis in two travelers from the united states.

    African trypanosomiasis is a rare but well-documented cause of fever in united states travelers returning from areas where it is endemic. We report two recently diagnosed cases that involved tourists who went on safari in tanzania. review of these and 29 other published cases indicates that disease in returning united states travelers is nearly always of the East African form, a fulminant illness for which prompt diagnosis is necessary. In the united states, timely and appropriate therapy for this disease has resulted in favorable outcomes for most patients. Chemoprophylaxis for East African trypanosomiasis is not recommended, but travelers visiting areas of endemicity should practice appropriate preventive measures to prevent tsetse fly bites. ( info)

3/37. Evidence for the occurrence of trypanosoma brucei rhodesiense sleeping sickness outside the traditional focus in south-eastern uganda.

    The occurrence of trypanosoma brucei rhodesiense west of the River Nile, in Masindi district in the mid-western part of uganda, is confirmed. Masindi borders the traditional belt of T. b. gambiense infection in the north-west, Gulu in the north and the Democratic Republic of congo in the west. Of the 702 persons tested for sleeping sickness in Masindi, 113 (16%) were positive by the card agglutination test for trypanosomiasis (CATT). Trypanosomes were observed in samples of cerebrospinal fluid (CSF) from two (0.3%) of the subjects: a 7-year-old girl, who had been ill for 2 weeks and yet was in good general condition, with three white blood cells (WBC)/microliter CSF; and a 47-year-old woman who had been ill for 8 months, looked sickly, had seven WBC/microliter CSF, but was still able to dig in her gardens. rats and mice inoculated with blood from the two parasitologically confirmed cases became parasitaemic on day 3 post-inoculation, indicating that the parasites were T. b. rhodesiense. Isoenzyme analysis revealed that the parasites isolated from one of these confirmed cases belonged to a zymodeme (449) which has not been previously observed among isolates from south-eastern or north-western uganda. Although the isolate shared PGM2 and ICD3 patterns with T. b. gambiense and T. b. rhodesiense, respectively, it did not have the SOD3:5 pattern characteristic of T. b. gambiense. The spread of T. b. rhodesiense beyond its traditional focus and the development of areas where this subspecies and T. b. gambiense are co-endemic will complicate the control of sleeping sickness in uganda; although the CATT is very useful for the mass screening of populations for T. b. gambiense area, it is not applicable in the detection of T. b. rhodesiense. ( info)

4/37. Cerebrospinal trypanosomiasis masquerading as pulmonary infectious disease in a 1-year-old boy.

    A 1-year-old boy with cerebrospinal trypanosomiasis presented with severe respiratory symptoms, hepatosplenomegaly and no neurological signs of trypanosomiasis. Agitation and high fever on the 2nd day in hospital prompted a lumbar puncture and trypanosomes were recovered from the cerebrospinal fluid. ( info)

5/37. African sleeping sickness in tourists returning from tanzania: the first 2 Italian cases from a small outbreak among European travelers.

    A recent cluster of cases of African trypanosomiasis in humans (HAT) has been reported in tourists (most of whom were European) returning from tanzania; we describe the first 2 patients (both of whom were Italian travelers) with HAT, who have been treated successfully. Because neither vaccine nor drug prophylaxis is currently recommended and/or available for persons traveling to areas of endemicity, physicians should be alerted about this uncommon but potentially life-threatening disease. ( info)

6/37. African trypanosomiasis in travelers returning to the United Kingdom.

    Two returning safari tourists with African trypanosomiasis were admitted to the Hospital for Tropical Diseases, london, in a 3-day period, compared with six cases in the previous 14 years. We describe the clinical features, diagnosis, and problems encountered in accessing appropriate therapy, and discuss the potential for emergence of this disease in increasingly adventurous international travelers. ( info)

7/37. Winterbottom's sign and hypertrophic cardiomyopathy.

    We present the case of a patient who presented with hypertrophic cardiomyopathy, generalized lymphadenopathy and serological evidence of African sleeping sickness (Trypanosoma gambiense). He made a full recovery after intravenous administration of eflornithine, a drug that is no longer distributed for antiparasitic indications for pharmacoeconomic reasons. ( info)

8/37. East African sleeping sickness in Chennai.

    A traveler to East africa developed fever, an eschar on his forearm and thrombocytopenia shortly after returning home to Chennai, india. trypanosoma brucei rhodesiense infection was diagnosed on examination of his peripheral smear. He made a full recovery after receiving a course of suramin. ( info)

9/37. MR imaging findings in African trypansomiasis.

    We report the initial and follow-up brain findings in a 42-year-old male patient with CNS involvement with African trypansomiasis. Initial MR imaging demonstrated diffuse hyperintensity in the basal ganglia bilaterally as well as involvement of the internal capsule, external capsule, and extreme capsule. Follow-up examination at 1 year revealed decreased signal intensity in the previously affected areas; however, ventricular enlargement indicative of atrophy was readily apparent. ( info)

10/37. Sleeping sickness in brothers in london.

    Brothers 9 and 14 years of age presented in london with fever and skin lesions after a safari in East africa. malaria films were negative, but trypanosomes were seen in blood films and chancre fluid. Sleeping sickness should be considered in children returning from East africa. ( info)
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