Human African trypanosomiasis: diagnosis, relapse and survival after severe melarsoprol-induced encephalopathy.

Abstract

We describe a case of human African trypanosomiasis with a number of unusual features. The clinical presentation was subacute, but the infection was shown to be due to Trypanosoma brucei rhodesiense. The infection relapsed twice following treatment and the patient developed a melarsoprol-associated encephalopathy. Magnetic resonance imaging (MRI) findings were suggestive of microhaemorrhages, well described in autopsy studies of encephalopathy but never before shown on MRI. The patient survived severe encephalopathy with a locked-in syndrome. Our decision to provide ongoing life support may be useful to physicians treating similar cases in a setting where intensive care facilities are available.

• Authors: A M Checkley, J Pepin, W C Gibson, M N Taylor, H R Jäger, D C Mabey
• Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg) Vol. 101 Issue 5 Pg. 523-6 (May 2007) ISSN: 0035-9203 [Print] England
• PMID: 17270227 (Publication Type: Case Reports, Journal Article)

Chemical References

• Trypanocidal Agents
• Melarsoprol

Topics

• Adult
• Animals
• Brain Diseases (chemically induced, diagnosis)
• Humans
• Magnetic Resonance Imaging
• Male
• Melarsoprol (adverse effects, therapeutic use)
• Polymerase Chain Reaction (methods)
• Recurrence
• Trypanocidal Agents (adverse effects, therapeutic use)
• Trypanosoma brucei rhodesiense (classification)
• Trypanosomiasis, African (diagnosis, drug therapy, mortality)