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 journalArticlepeer-review

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 languageEnglish (US)
Article numberofab377
JournalOpen Forum Infectious Diseases
Volume8
Issue number8
DOIs
StatePublished - Aug 1 2021

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

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