African trypanosomiasis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Pilar Almonacid; Jesus Rosario Hernandez, M.D. [2]

Overview

The diagnosis of African trypanosomiasis rests on demonstrating trypanosomes by microscopic examination of chancre fluid, lymph node aspirates, blood, bone marrow, and cerebrospinal fluid in the late stages of infection.

Laboratory Findings

The diagnosis of African trypanosomiasis rests on demonstrating trypanosomes by microscopic examination of chancre fluid, lymph node aspirates, blood, bone marrow or, in the late stages of infection, in cerebrospinal fluid.

Blood smear

• Acute disease is often diagnosed by visual detection of the Trypanosoma brucei rhodesiense parasite on peripheral blood smear.
• Peripheral blood smears are usually stained with Giemsa stain for adequate visualization of the parasite.

Microscopy	Findings
African trypanosomiasis	Thin blood smear stained with Giemsa. Typical trypomastigote stages (the only stages found in patients), with a posterior kinetoplast, a centrally located nucleus, an undulating membrane, and an anterior flagellum.   The two Trypanosoma brucei species that cause human trypanosomiasis, Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiens, are indistinguishable morphologically.   The trypanosomes' length range is 14 to 33 µm.
African trypanosomiasis 5	Dividing parasite is seen at the right.

Electrolyte and Biomarker Studies

• Serology is not usually helpful in acute disease.
• Detection of anti-trypanosomal IgG antibodies is helpful to detect African trypanosomiasis infections.
• Three serological tests are available for detection of the parasite: micro-CATT, wb-CATT, and wb-LATEX. The first uses dried blood while the other two use whole blood samples.
• wb-CATT is the most efficient for diagnosis, while wb-LATEX is a better exam for situations in which greater sensitivity is required.
• Detection of antibodies among infants may be difficult due to the presence of maternal antibodies early following birth. Accordingly, serologic testing for infants is only recommended at least 9 months after birth.

Gallery

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL).

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL).

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL).

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL).

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL).

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL).

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL).

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  African trypanosomiasis. Adapted from Public Health Image Library (PHIL).