A Wandering Missionary's Burden: Persistent Fever and Progressive Somnolence in a Returning Traveler

Kruti J. Yagnik; Alonso Pezo-Salazar; David Rosenbaum; Jesse Manuel Jaso; Dominick Cavuoti; Benjamin Nelson; Rebecca J. Chancey; Megan L. Mckenna; Laila M. Castellino

doi:10.1093/ofid/ofab377

A Wandering Missionary's Burden: Persistent Fever and Progressive Somnolence in a Returning Traveler

Kruti J. Yagnik, Alonso Pezo-Salazar, David Rosenbaum, Jesse Manuel Jaso, Dominick Cavuoti, Benjamin Nelson, Rebecca J. Chancey, Megan L. Mckenna, Laila M. Castellino

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Human African trypanosomiasis incidence has declined, but diagnosis remains difficult, especially in nonendemic areas. Our patient presented with fever, progressive lethargy, and weight loss for 5 months and had previously traveled to Ghana and Cameroon but had not been to areas with recently reported African trypanosomiasis. Extensive workup was negative, except for lymphocytic pleocytosis in cerebrospinal fluid; ultimately, a bone marrow aspiration revealed necrotizing granulomatous inflammation with 2 trypanosomes discovered on the aspirate smear, consistent with Trypanosoma brucei. The patient was treated with combination nifurtimox and eflornithine with full recovery.

Original language	English (US)
Article number	ofab377
Journal	Open Forum Infectious Diseases
Volume	8
Issue number	8
DOIs	https://doi.org/10.1093/ofid/ofab377
State	Published - Aug 1 2021

Keywords

African sleeping sickness
Trypanosoma brucei
fever in a returning traveler
human African trypanosomiasis

ASJC Scopus subject areas

Infectious Diseases
Oncology

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10.1093/ofid/ofab377

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title = "A Wandering Missionary's Burden: Persistent Fever and Progressive Somnolence in a Returning Traveler",

abstract = "Human African trypanosomiasis incidence has declined, but diagnosis remains difficult, especially in nonendemic areas. Our patient presented with fever, progressive lethargy, and weight loss for 5 months and had previously traveled to Ghana and Cameroon but had not been to areas with recently reported African trypanosomiasis. Extensive workup was negative, except for lymphocytic pleocytosis in cerebrospinal fluid; ultimately, a bone marrow aspiration revealed necrotizing granulomatous inflammation with 2 trypanosomes discovered on the aspirate smear, consistent with Trypanosoma brucei. The patient was treated with combination nifurtimox and eflornithine with full recovery.",

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AU - Pezo-Salazar, Alonso

AU - Rosenbaum, David

AU - Jaso, Jesse Manuel

AU - Cavuoti, Dominick

AU - Nelson, Benjamin

AU - Chancey, Rebecca J.

AU - Mckenna, Megan L.

AU - Castellino, Laila M.

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AB - Human African trypanosomiasis incidence has declined, but diagnosis remains difficult, especially in nonendemic areas. Our patient presented with fever, progressive lethargy, and weight loss for 5 months and had previously traveled to Ghana and Cameroon but had not been to areas with recently reported African trypanosomiasis. Extensive workup was negative, except for lymphocytic pleocytosis in cerebrospinal fluid; ultimately, a bone marrow aspiration revealed necrotizing granulomatous inflammation with 2 trypanosomes discovered on the aspirate smear, consistent with Trypanosoma brucei. The patient was treated with combination nifurtimox and eflornithine with full recovery.

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A Wandering Missionary's Burden: Persistent Fever and Progressive Somnolence in a Returning Traveler

Abstract

Keywords

ASJC Scopus subject areas

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