African trypanosomiasis, or African sleeping sickness, is a parasitic infection caused by the protozoa Protozoa Nitroimidazoles Trypanosoma brucei. There are 2 notable subtypes, T. brucei gambiense and T. brucei rhodesiense. Transmission is primarily vector borne through the tsetse fly. Initial infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease present with localized inflammation Inflammation Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body's defense against pathogenic organisms. Inflammation is also seen as a response to tissue injury in the process of wound healing. The 5 cardinal signs of inflammation are pain, heat, redness, swelling, and loss of function. Inflammation ( chancre Chancre The primary sore of syphilis, a painless indurated, eroded papule, occurring at the site of entry of the infection. Syphilis), cervical lymphadenopathy Lymphadenopathy Lymphadenopathy is lymph node enlargement (> 1 cm) and is benign and self-limited in most patients. Etiologies include malignancy, infection, and autoimmune disorders, as well as iatrogenic causes such as the use of certain medications. Generalized lymphadenopathy often indicates underlying systemic disease. Lymphadenopathy, intermittent fevers, and other nonspecific findings. If untreated, CNS involvement occurs, which is characterized by sleep Sleep A readily reversible suspension of sensorimotor interaction with the environment, usually associated with recumbency and immobility. Physiology of Sleep disturbances, behavioral changes, coma Coma Coma is defined as a deep state of unarousable unresponsiveness, characterized by a score of 3 points on the GCS. A comatose state can be caused by a multitude of conditions, making the precise epidemiology and prognosis of coma difficult to determine. Coma, and death. Diagnosis is confirmed by the identification Identification Defense Mechanisms of trypanosomes on blood smear Blood smear Myeloperoxidase Deficiency or serology Serology The study of serum, especially of antigen-antibody reactions in vitro. Yellow Fever Virus. Treatment is dependent on the subtype and stage of the disease. Early treatment and prevention are key in preventing long-term sequelae and death.
Last updated: 28 Oct, 2021
Trypanosomes in a Giemsa-stained thin blood film from a traveler returning from Tanzania
Image: “Trypanosomes in a Giemsa-stained thin blood film from a Spanish traveler returning from Tanzania” by Joan Gómez-Junyent et al AL Amyloidosis. License: CC BY 4.0T. brucei causes African trypanosomiasis, also known as African sleeping sickness.
Geographic distribution of African trypanosomiasis: T. brucei is only found in the blue areas.
Image: “T. brucei is only found in the blue areas” by Beck, H.E. et al AL Amyloidosis. License: CC BY 4.0Image illustrating the pathogenesis of African trypanosomiasis
Image by Lecturio. License: CC BY-NC-SA 4.0African trypanosomiasis has 2 stages: the hemolymphatic stage and the neurologic stage
Cutaneous manifestations of African trypanosomiasis:
A: a fine, pink
rash
Rash
Rocky Mountain Spotted Fever on the abdomen
B: trypanosomal
chancre
Chancre
The primary sore of syphilis, a painless indurated, eroded papule, occurring at the site of entry of the infection.
Syphilis on the patient’s left
arm
Arm
The arm, or “upper arm” in common usage, is the region of the upper limb that extends from the shoulder to the elbow joint and connects inferiorly to the forearm through the cubital fossa. It is divided into 2 fascial compartments (anterior and posterior).
Arm: Anatomy that occurs at the site of inoculation
Image showing the time course of African trypanosomiasis from initial infection to chronic illness months to years later (depending on the subspecies involved)
Image by Lecturio. License: CC BY-NC-SA 4.0Protozoa Protozoa Nitroimidazoles | Giardia Giardia A genus of flagellate intestinal eukaryotes parasitic in various vertebrates, including humans. Characteristics include the presence of four pairs of flagella arising from a complicated system of axonemes and cysts that are ellipsoidal to ovoidal in shape. Nitroimidazoles | Leishmania Leishmania Leishmania species are obligate intracellular parasites that are transmitted by an infected sandfly. The disease is endemic to Asia, the Middle East, Africa, the Mediterranean, and South and Central America. Clinical presentation varies, dependent on the pathogenicity of the species and the host’s immune response. Leishmania/Leishmaniasis | Trypanosoma | Trichomonas Trichomonas A genus of parasitic flagellate eukaryotes distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. Nitroimidazoles |
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Giemsa staining of Giardia Giardia A genus of flagellate intestinal eukaryotes parasitic in various vertebrates, including humans. Characteristics include the presence of four pairs of flagella arising from a complicated system of axonemes and cysts that are ellipsoidal to ovoidal in shape. Nitroimidazoles lamblia trophozoites Trophozoites Cells or feeding stage in the life cycle of sporozoan protozoa. In the malarial parasite, the trophozoite develops from the merozoite and then splits into the schizont. Trophozoites that are left over from cell division can go on to form gametocytes. Amebicides
Image: “ Trophozoites Trophozoites Cells or feeding stage in the life cycle of sporozoan protozoa. In the malarial parasite, the trophozoite develops from the merozoite and then splits into the schizont. Trophozoites that are left over from cell division can go on to form gametocytes. Amebicides of Giardia Giardia A genus of flagellate intestinal eukaryotes parasitic in various vertebrates, including humans. Characteristics include the presence of four pairs of flagella arising from a complicated system of axonemes and cysts that are ellipsoidal to ovoidal in shape. Nitroimidazoles lamblia” by Eva NohĂ˝nková, Department of Tropical Medicine, 1st Faculty of Medicine, Charles University in Prague and Hospital Bulovka, Czech Republic. License: CC BY 4.0Giemsa staining of Leishmania Leishmania Leishmania species are obligate intracellular parasites that are transmitted by an infected sandfly. The disease is endemic to Asia, the Middle East, Africa, the Mediterranean, and South and Central America. Clinical presentation varies, dependent on the pathogenicity of the species and the host’s immune response. Leishmania/Leishmaniasis promastigotes
Image: “ Giemsa stain Giemsa stain Borrelia” by Arriyadh Community College, King Saud University, P.O. Box 28095, Riyadh 11437, Saudi Arabia. License: CC BY 3.0Microscopy images of Trichomonas Trichomonas A genus of parasitic flagellate eukaryotes distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. Nitroimidazoles vaginalis trophozoites Trophozoites Cells or feeding stage in the life cycle of sporozoan protozoa. In the malarial parasite, the trophozoite develops from the merozoite and then splits into the schizont. Trophozoites that are left over from cell division can go on to form gametocytes. Amebicides
Image: “ Trichomonas Trichomonas A genus of parasitic flagellate eukaryotes distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. Nitroimidazoles protozoa Protozoa Nitroimidazoles” by isis325. License: CC BY 2.0.