African trypanosomiasis history and symptoms: Difference between revisions
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{{African trypanosomiasis}} | {{African trypanosomiasis}} | ||
{{CMG}}; {{AOEIC}} Pilar Almonacid {{ADG}} | {{CMG}}; {{AOEIC}} Pilar Almonacid, {{ADG}} | ||
==Overview== | ==Overview== | ||
The clinical course of human [[African trypanosomiasis]] has two stages. In the first stage, the [[Parasites|parasite]] is found in the peripheral circulation but it has not yet invaded the [[central nervous system]]. Once the [[Parasites|parasite]] crosses the [[blood-brain barrier]] and infects the [[central nervous system]], the [[disease]] enters the second stage. The subspecies that cause [[African trypanosomiasis]] have different rates of disease progression, and the clinical features depend on which form of the [[Parasites|parasite]] ([[Trypanosoma brucei rhodesiense]] or [[Trypanosoma brucei gambiense]]) is causing the infection. However, infection with either form will eventually lead to [[coma]] and death if not treated. | The clinical course of human [[African trypanosomiasis]] has two stages. In the first stage, the [[Parasites|parasite]] is found in the peripheral [[circulation]] but it has not yet invaded the [[central nervous system]]. Once the [[Parasites|parasite]] crosses the [[blood-brain barrier]] and [[Infection|infects]] the [[central nervous system]], the [[disease]] enters the second stage. The [[subspecies]] that cause [[African trypanosomiasis]] have different rates of [[disease]] progression, and the clinical features depend on which form of the [[Parasites|parasite]] (''[[Trypanosoma brucei rhodesiense]]'' or ''[[Trypanosoma brucei gambiense]]'') is causing the [[infection]]. However, [[infection]] with either form will eventually lead to [[coma]] and death if not treated. | ||
==History== | ==History== | ||
Obtaining the history is the most important aspect of making a diagnosis of African trypanosomiasis. It provides insight into cause, precipitating factors, and associated [[Comorbidity|comorbid]] conditions. A patient suffering from African trypanosimiasis may present with the following history: | |||
* | *Recent travel to the [[Endemic (epidemiology)|endemic]] areas | ||
*Any ill contact with similar complaints | *Any ill contact with similar complaints | ||
==Symptoms== | ==Symptoms== | ||
Symptoms of African trypanosomiasis include:<ref name="pmid19833383">{{cite journal |vauthors=Brun R, Blum J, Chappuis F, Burri C |title=Human African trypanosomiasis |journal=Lancet |volume=375 |issue=9709 |pages=148–59 |year=2010 |pmid=19833383 |doi=10.1016/S0140-6736(09)60829-1 |url=}}</ref><ref name="pmid17582444">{{cite journal |vauthors=Masocha W, Rottenberg ME, Kristensson K |title=Migration of African trypanosomes across the blood-brain barrier |journal=Physiol. Behav. |volume=92 |issue=1-2 |pages=110–4 |year=2007 |pmid=17582444 |doi=10.1016/j.physbeh.2007.05.045 |url=}}</ref><ref name="pmid18261232">{{cite journal |vauthors=Checchi F, Filipe JA, Haydon DT, Chandramohan D, Chappuis F |title=Estimates of the duration of the early and late stage of gambiense sleeping sickness |journal=BMC Infect. Dis. |volume=8 |issue= |pages=16 |year=2008 |pmid=18261232 |pmc=2259357 |doi=10.1186/1471-2334-8-16 |url=}}</ref><ref name="pmid9557424">{{cite journal |vauthors=Odiit M, Kansiime F, Enyaru JC |title=Duration of symptoms and case fatality of sleeping sickness caused by Trypanosoma brucei rhodesiense in Tororo, Uganda |journal=East Afr Med J |volume=74 |issue=12 |pages=792–5 |year=1997 |pmid=9557424 |doi= |url=}}</ref> | [[Symptoms]] of African trypanosomiasis include:<ref name="pmid19833383">{{cite journal |vauthors=Brun R, Blum J, Chappuis F, Burri C |title=Human African trypanosomiasis |journal=Lancet |volume=375 |issue=9709 |pages=148–59 |year=2010 |pmid=19833383 |doi=10.1016/S0140-6736(09)60829-1 |url=}}</ref><ref name="pmid17582444">{{cite journal |vauthors=Masocha W, Rottenberg ME, Kristensson K |title=Migration of African trypanosomes across the blood-brain barrier |journal=Physiol. Behav. |volume=92 |issue=1-2 |pages=110–4 |year=2007 |pmid=17582444 |doi=10.1016/j.physbeh.2007.05.045 |url=}}</ref><ref name="pmid18261232">{{cite journal |vauthors=Checchi F, Filipe JA, Haydon DT, Chandramohan D, Chappuis F |title=Estimates of the duration of the early and late stage of gambiense sleeping sickness |journal=BMC Infect. Dis. |volume=8 |issue= |pages=16 |year=2008 |pmid=18261232 |pmc=2259357 |doi=10.1186/1471-2334-8-16 |url=}}</ref><ref name="pmid9557424">{{cite journal |vauthors=Odiit M, Kansiime F, Enyaru JC |title=Duration of symptoms and case fatality of sleeping sickness caused by Trypanosoma brucei rhodesiense in Tororo, Uganda |journal=East Afr Med J |volume=74 |issue=12 |pages=792–5 |year=1997 |pmid=9557424 |doi= |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
!Stages of infection | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stages of infection | ||
!Symptoms | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Symptoms | ||
|- | |- | ||
|Systemic | |[[Systemic]] | ||
| | | | ||
* [[Sweating]] | * [[Sweating]] | ||
| Line 24: | Line 24: | ||
| | | | ||
* [[Headaches]] | * [[Headaches]] | ||
* [[ | * [[Myalgias]] | ||
* [[Pruritis]] | |||
|- | |- | ||
|Second stage ([[neurological]] or [[Meningoencephalitis|meningoencephalic]] stage) | |Second stage ([[neurological]] or [[Meningoencephalitis|meningoencephalic]] stage) | ||
| | | | ||
* Changes | * Changes in behavior | ||
* [[Confusion]] | * [[Confusion]] | ||
* Sensory disturbances | * [[Sensory]] disturbances | ||
* Poor coordination | * Poor [[Motor coordination|coordination]] | ||
* Disturbance of the sleep cycle | * Disturbance of the sleep cycle | ||
|} | |} | ||
The [[subspecies]] that cause [[African trypanosomiasis]] have different rates of [[disease]] progression | The [[subspecies]] that cause [[African trypanosomiasis]] have different rates of [[disease]] progression and the clinical features depend on which form of the [[Parasites|parasite]] (''[[Trypanosoma brucei rhodesiense]]'' or ''[[Trypanosoma brucei gambiense]]'') is causing the [[infection]]. | ||
{| class="wikitable" | {| class="wikitable" | ||
| Line 54: | Line 55: | ||
| | | | ||
* A large sore (a [[chancre]]) will develop at the site of the [[Tsetse fly|tsetse]] bite | * A large sore (a [[chancre]]) will develop at the site of the [[Tsetse fly|tsetse]] bite | ||
* [[Fever]], [[headache]], [[muscle]] and [[joint aches]], and [[Enlarged lymph nodes|enlarged lymph | * [[Fever]], [[headache]], [[muscle]] and [[joint aches]], and [[Enlarged lymph nodes|enlarged lymph nodes]] | ||
| | | | ||
* Mental deterioration and other [[Neurologic diseases|neurologic]] problems. Death ensues usually within months | * Mental deterioration and other [[Neurologic diseases|neurologic]] problems. Death ensues usually within months. | ||
|- | |- | ||
|West African sleeping sickness | |West African sleeping sickness | ||
| Line 64: | Line 65: | ||
(1-2 years) | (1-2 years) | ||
| | | | ||
* Intermittent [[fevers]], [[headaches]], [[muscle]] and [[joint aches]], and [[malaise]] | * Intermittent [[fevers]], [[headaches]], [[muscle]] and [[joint aches]], and [[malaise]] | ||
* [[Itching]] of the skin, [[swollen lymph nodes]], and [[weight loss]] | * [[Itching]] of the skin, [[swollen lymph nodes]], and [[weight loss]] | ||
| | | | ||
* [[Personality changes]], [[daytime sleepiness]] with nighttime sleep disturbance, and progressive [[confusion]] | * [[Personality changes]], [[daytime sleepiness]] with nighttime sleep disturbance, and progressive [[confusion]]. | ||
* Other [[neurologic]] signs, such as partial [[paralysis]] or problems with [[Balance disorder|balance]] or walking may occur, as well as [[Hormonal|hormonal imbalances]] | * Other [[neurologic]] signs, such as partial [[paralysis]] or problems with [[Balance disorder|balance]] or walking may occur, as well as [[Hormonal|hormonal imbalances]]. | ||
* The course of untreated infection rarely lasts longer than 6-7 years and more often kills in about 3 years. | * The course of untreated infection rarely lasts longer than 6-7 years and more often kills in about 3 years. | ||
|} | |} | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
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[[Category:Neurology]] | [[Category:Neurology]] | ||
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[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
Latest revision as of 20:19, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Pilar Almonacid, Aditya Ganti M.B.B.S. [2]
Overview
The clinical course of human African trypanosomiasis has two stages. In the first stage, the parasite is found in the peripheral circulation but it has not yet invaded the central nervous system. Once the parasite crosses the blood-brain barrier and infects the central nervous system, the disease enters the second stage. The subspecies that cause African trypanosomiasis have different rates of disease progression, and the clinical features depend on which form of the parasite (Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense) is causing the infection. However, infection with either form will eventually lead to coma and death if not treated.
History
Obtaining the history is the most important aspect of making a diagnosis of African trypanosomiasis. It provides insight into cause, precipitating factors, and associated comorbid conditions. A patient suffering from African trypanosimiasis may present with the following history:
- Recent travel to the endemic areas
- Any ill contact with similar complaints
Symptoms
Symptoms of African trypanosomiasis include:[1][2][3][4]
| Stages of infection | Symptoms |
|---|---|
| Systemic | |
| First stage (hemo-lyphatic stage) | |
| Second stage (neurological or meningoencephalic stage) |
|
The subspecies that cause African trypanosomiasis have different rates of disease progression and the clinical features depend on which form of the parasite (Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense) is causing the infection.
| Disease | Pathogen | Geographic
distrubution |
Progression | Symptoms | |
|---|---|---|---|---|---|
| First stage | Second stage | ||||
| East African sleeping sickness | Trypanosoma brucei rhodesiense | East and Southeast Africa | Rapid
(1-2 weeks) |
|
|
| West African sleeping sickness | Trypanosoma brucei gambiense | West and Central Africa | Slow
(1-2 years) |
|
|
References
- ↑ Brun R, Blum J, Chappuis F, Burri C (2010). "Human African trypanosomiasis". Lancet. 375 (9709): 148–59. doi:10.1016/S0140-6736(09)60829-1. PMID 19833383.
- ↑ Masocha W, Rottenberg ME, Kristensson K (2007). "Migration of African trypanosomes across the blood-brain barrier". Physiol. Behav. 92 (1–2): 110–4. doi:10.1016/j.physbeh.2007.05.045. PMID 17582444.
- ↑ Checchi F, Filipe JA, Haydon DT, Chandramohan D, Chappuis F (2008). "Estimates of the duration of the early and late stage of gambiense sleeping sickness". BMC Infect. Dis. 8: 16. doi:10.1186/1471-2334-8-16. PMC 2259357. PMID 18261232.
- ↑ Odiit M, Kansiime F, Enyaru JC (1997). "Duration of symptoms and case fatality of sleeping sickness caused by Trypanosoma brucei rhodesiense in Tororo, Uganda". East Afr Med J. 74 (12): 792–5. PMID 9557424.