Sleeping sickness = African trypanosomiasis

Sleeping sickness, AKA African trypanosomiasis, is a tropical illness spread by the tsetse fly. 

It is caused by 
  • trypanosoma brucei gambiense 
    • West and central Africa 
    • Slow progression, 1 year to reach 2nd stage disease
    • If untreated, death in 3 years 
  • trypanosoma brucei rhodesiense 
    • east and south Africa
    • fast progression, 3 weeks to reach 2nd stage disease 
    • If untreated, death in 6 to 12 months 

First stage - blood
  • Fever, headache, loss of appetite 
  • Lymphadenopathy, splenomegaly, hepatomegaly 
  • Possibly a chancre at site of bite in t.rhodesiense 
  • Treatment
    • t. gambiense – eflornithine 
    • t. rhodesiense – suramin 

Second stage - CNS
  • Sleeping during the day 
  • Headache 
  • Neuro-psychiatric signs and symptoms
  • Motor signs 
  • Treatment 
    • Melarsoprol for both 

Diagnosis is by microscopy of blood or CSF. 



Small print gem: In sleeping sickness, lympadenopathy in the posterior triangle of the neck is known as Winterbottom’s sign. 


References:
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Sarah Hudson

Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas.

Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)