Trypanosoma brucei-gambiense (African sleeping sickness)

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Introduction

Etiologic agent of west African trypanosomiasis (classic African sleeping sickness).

Epidemiology

Clinical manifestations

Management

  • suramin (stage I, normal CSF)
    • 100-200 mg IV test dose to detect hypersensitivity
    • adults: 1 g IV on days 1,3,7,14 & 21
    • children: 20 mg/kg/day (max 1 g) IV on days 1,3,7,14 & 21
    • slow IV infusion of freshly prepared 10% aqueous solution
  • eflornithine (stage I normal CSF or stage II, abnormal CSF)
    • highly effective for stage I or stage II
    • 90% cure rate for stage II disease
    • 400 mg/kg/day IV in 4 divided QID for 2 weeks
    • followed by 300 mg/kg/day PO for 3-4 weeks
  • pentamidine
    • alternative agent for stage I
    • 4 mg/kg/day IV or IM for 10 days
  • no vaccine available

More general terms

Additional terms

References

  1. Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1266
  2. Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
  3. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1193-96