Trypanosoma brucei rhodesiense
(tri-pan-o-so-ma / brew-see-eye / rho-dee-see-ense)
Basic Information
This parasite is located throughout Central and Eastern Africa.
Transmission
A human can get this parasite by the bite from an infected tsetse fly. The species of fly that carry this parasite are Glossina pallidipes, Glossina morsitans and Glossina swynnertoni. The reservoir hosts include antelope and domestic cattle.
Disease
East African sleeping sickness
- The clinical presentation of this disease is very similar to T. b. gambiense but is characterized by more severe symptoms and progresses rapidly.
- Has a short incubation period.
- Symptoms include:
- febrile episodes
- headaches, malaise, weakness, anorexia and night sweats
- inflammation of the glomerulus of the kidney (glomerulonephritis)
- inflammation of the heart (myocarditis)
- Inflammation of the lymph nodes and Winterbottom's sign are less pronounced.
- If left untreated, the patient usually dies before displaying the prolonged somnolence (sleepiness).
- Entire course of disease may take only 9-12 months.
Diagnostic
- Laboratory specimen
- blood (use buffy coat)
- will see trypomastigotes during febrile episodes
- spinal fluid
- will see trypomastigotes once the CNS symptoms start
- lymph node aspirates
- will see trypomastigotes
- blood (use buffy coat)
- Testing
- permanent smears made with Giemsa stain
- direct wet mount will show motile trypomastigotes
- Card Agglutination Trypanosomiasis Test (CATT)
Treatment
Early patient management is critical to successful treatment. Prognosis is poor once the central nervous system symptoms start. The drugs that are used for treatment are pentamidine, suramin and melarsoprol. All of the drugs are considered toxic but melarsoprol is the most toxic. It is a trivalent arsenic compound and is used once the central nervous system is involved and the patient is in the late stages of the disease. Pentamidine is the drug of choice if the disease is caught in the early stages.