Tuesday, October 26, 2021

Case of the Week 658

This week's case is a thick blood film from a patient with fever and recent travel to East Africa. Diagnosis? Would you like any additional studies?


7 comments:

Anonymous said...

Looks like human African trypanosomiasis, and with the travel history to East Africa it might specifically be due to Trypanosoma brucei rhodesiense. The most important additional test would be a lumbar puncture for disease staging, which in T. b. rhodesiense is very important given the treatment regimens for the haemolymphatic and meningoencephalitic stages are very different.

LS

Anonymous said...

Very nice case of trypanosomiasis. With a history of travel to East Africa, my bet is Trypanosoma brucei rhodesiene too. I would concur with LS on the additional testing.
Florida Fan

Anonymous said...

Gorgeous photos. Would Anonymous tell us what the different treatments would be between for this trypanosome? That would be interesting.
BW,a retired pathologist in Vt

Sir Galahad said...

East Africa? Probabilmente Trypanosoma brucei rhodesiense.

Blaine A. Mathison said...

Got tryp on a trip? What a trip!

Anonymous said...

One can always get a rhyme out of Blaine, but not Blaine out of the rhymes.
Florida Fan

Anonymous said...

Hi BW, I believe the treatment for early stage Rhodesian trypanosomiasis would be suramin, or alternatively pentamidine. But the only treatment for late stage disease is melarsoprol, which is also highly toxic. The latest advances in treatment of African trypanosomiasis have mainly been in Gambian (or Western) trypanosomiasis (T. b. gambiense); these being nifurtimox-eflornithine combination therapy (NECT) and fexinidazole. That being said, the Drugs for Neglected Diseases Initiative (DNDi) is working on clinical trials for fexinidazole for Rhodesian trypanosomiasis.

LS