African trypanosomiasis history and symptoms: Difference between revisions

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Latest revision as of 20:19, 29 July 2020

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	Sweating Anxiety Fever
First stage (hemo-lyphatic stage)	Headaches Myalgias Pruritis
Second stage (neurological or meningoencephalic stage)	Changes in behavior Confusion Sensory disturbances Poor coordination Disturbance of the sleep cycle

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
Disease	Pathogen	Geographic distrubution	Progression	First stage	Second stage
East African sleeping sickness	Trypanosoma brucei rhodesiense	East and Southeast Africa	Rapid (1-2 weeks)	A large sore (a chancre) will develop at the site of the tsetse bite Fever, headache, muscle and joint aches, and enlarged lymph nodes	Mental deterioration and other neurologic problems. Death ensues usually within months.
West African sleeping sickness	Trypanosoma brucei gambiense	West and Central Africa	Slow (1-2 years)	Intermittent fevers, headaches, muscle and joint aches, and malaise Itching of the skin, swollen lymph nodes, and weight loss	Personality changes, daytime sleepiness with nighttime sleep disturbance, and progressive confusion. Other neurologic signs, such as partial paralysis or problems with balance or walking may occur, as well as hormonal imbalances. The course of untreated infection rarely lasts longer than 6-7 years and more often kills in about 3 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.

Template:WikiDoc Sources

[pmid19833383-1] 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.

[pmid17582444-2] 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.

[pmid18261232-3] 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.

[pmid9557424-4] 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.

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[4]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{African trypanosomiasis}}
-{{CMG}}; {{AOEIC}} Pilar Almonacid
+{{CMG}}; {{AOEIC}} Pilar Almonacid, {{ADG}}
+==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 [[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==
+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
 ==Symptoms==
-General symptoms of African trypanosomiasis include:
+[[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"
+! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stages of infection
+! style="background:#4479BA; color: #FFFFFF;" align="center" + |Symptoms
+|-
+|[[Systemic]]
+|
+* [[Sweating]]
 * [[Anxiety]]
-* [[Drowsiness]]
 * [[Fever]]
-* [[Headache]]
+|-
-* Increased sleepiness
+|First stage (hemo-lyphatic stage)
-* [[Insomnia]] at night
+|
-* Mood changes
+* [[Headaches]]
-* [[Sweating]]
+* [[Myalgias]]
-* Swollen [[lymph nodes]] all over the body
+* [[Pruritis]]
-* Swollen, red, painful nodule at site of fly bite
+|-
-* Uncontrollable urge to sleep
+|Second stage ([[neurological]] or [[Meningoencephalitis|meningoencephalic]] stage)
+|
+* Changes in behavior
+* [[Confusion]]
+* [[Sensory]] disturbances
+* Poor [[Motor coordination|coordination]]
+* Disturbance of the sleep cycle
+|}
+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"
-!
+! rowspan="2" |Disease
-!Symptoms
+! rowspan="2" |Pathogen
+! rowspan="2" |Geographic
+distrubution
+! rowspan="2" |Progression
+! colspan="2" |Symptoms
 |-
-|First stage (hemo-lyphatic stage)
+|First stage
+|Second stage
+|-
+|East African sleeping sickness
+|[[Trypanosoma brucei rhodesiense|''Trypanosoma brucei'' rhodesiense]]
+|East and Southeast Africa
+|Rapid
+(1-2 weeks)
+|
+* 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 nodes]]
 |
-* Fever
+* Mental deterioration and other [[Neurologic diseases|neurologic]] problems. Death ensues usually within months.
-* Headaches
-* Joint pains and itching
 |-
-|Second stage (neurological or meningo-encephalic stage)
+|West African sleeping sickness
+|[[Trypanosoma brucei gambiense|''Trypanosoma brucei'' gambiense]]
+|West and Central Africa
+|Slow
+(1-2 years)
 |
-* Changes of behaviour
+* Intermittent [[fevers]], [[headaches]], [[muscle]] and [[joint aches]], and [[malaise]]
-* Confusion
+* [[Itching]] of the skin, [[swollen lymph nodes]], and [[weight loss]]
-* Sensory disturbances
+|
-* Poor coordination
+* [[Personality changes]], [[daytime sleepiness]] with nighttime sleep disturbance, and progressive [[confusion]].
-* Disturbance of the sleep cycle,
+* 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.
 |}
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