African trypanosomiasis differential diagnosis

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Overview

The hemo-lymphatic stage of African trympanosomiasis presents with a rash, fever and anemia and must be differentiated from other diseases such as brucellosis, typhoid fever, malaria, tuberculosis, lymphoma, Dengue, Leptospirosis. The most prominent symptom in neurological stage of African trypanosomiasis is mental status changes and sleep disturbances, differential diagnoses in CNS TB, meningitis, and HIV-related opportunistic infections, including cryptococcal meningitis.[1][2][3][4]

Differentiating African trypanosomiasis from other diseases

The hemo-lymphatic stage of African trympnosomiasis presents with a rash, fever and anemia and must be differentiated from other diseases such as brucellosis, typhoid fever, malaria, tuberculosis, lymphoma, Dengue, Leptospirosis.



The differential diagnosis of African trypanosomiasis is given in this comparative table below:


Differential diagnosis of Brucellosis Symptoms Signs Diagnosis Additional Findings
Fever Rash Diarrhea Abdominal pain Weight loss Painful lymphadenopathy Hepatosplenomegaly Arthritis Lab Findings
Brucellosis + + - + + + + + Relative lymphocytosis

Night sweats, often with characteristic smell, likened to wet hay

Typhoid fever + + - + - - + + Decreased hemoglobin Incremental increase in temperature initially and than sustained fever as high as 40°C (104°F)
Malaria + - + + - - + + Microcytosis,

elevated LDH

"Tertian" fever: paroxysms occur every second day
Tuberculosis + + - + + + - + Mild normocytic anemia, hyponatremia, and

hypercalcemia

Night sweats, constant fatigue
Lymphoma + - - + + - + - Increase ESR, increased LDH Night sweats, constant fatigue
Mumps + - - - - + - - Relative lymphocytosis, serum amylase elevated Parotid swelling/tenderness
HIV - - - + + + - + Constant fatigue

References

  1. 1.0 1.1 Pappas G, Akritidis N, Bosilkovski M, Tsianos E (2005). "Brucellosis". N Engl J Med. 352 (22): 2325–36. doi:10.1056/NEJMra050570. PMID 15930423.
  2. Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on January,2017
  3. 3.0 3.1 Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management". Curr Clin Top Infect Dis. 15: 115–28. PMID 7546364.
  4. 4.0 4.1 Enfermedades infecciosas: Brucelosis -Diagnóstico de Brucelosis,Guia para el Equipo de Salud. Ministerio de Salud-Argentina. http://www.msal.gob.ar/images/stories/bes/graficos/0000000304cnt-guia-medica-brucelosis.pdf. Accessed on February 2, 2016
  5. Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on January,2017