West-African trypanosomiasis in a returned traveller from Ghana: an unusual cause of progressive neurological decline

Abstract

SUMMARYWest-African trypanosomiasis caused by Trypanosoma brucei gambiense is a rare imported infection presenting with somnolence, lymphadenopathy and wide-ranging neurological symptoms. A 67-year-old Caucasian man presented with a 10-month history of cognitive deterioration, ataxic gait, somnolence and urinary incontinence. His symptoms had progressed more rapidly over the course of a month prior to admission. Serological testing confirmed a diagnosis of West-African trypanosomiasis. The patient was successfully treated with eflornithine and made a good recovery. WestAfrican trypanosomiasis should be considered in the differential diagnosis of unexplained cognitive decline in those with a relevant travel history. If left untreated, the condition is universally fatal. BACKGROUND

Unusual MRI Findings in African Trypanosoma brucei gambiense Trypanosomiasis: Dentate Nuclei and Hypothalamic Lesions

“…More rarely the BS is involved: FLAIR hyperintensities at the central pons (4/11) (present case [2][3][4] ), at the anterior aspect of the midbrain (3/11) (present case 1 ), and at the medulla oblongata (present case) have been reported. Other rare lesions, appearing as FLAIR hyperintensities, involve the CN (3/11) (present case [1][2][3][4] ), bilateral middle cerebellar peduncles (2/11), [1][2][3][4][5] and the corpus callosum. 5 Another interesting finding was the symmetric distribution of the lesions on MRI in 6/11 cases (present case [3][4][5] ) and almost symmetric in two other cases.…”

“…In patients with neurological deficits, MRI demonstrates specific findings (11 reported cases with enough MRI data obtained before melarsoprol treatment was initiated, including ours). [1][2][3][4][5] Large WM hyperintensities are the most common finding (9/11; internal/external capsule: 5/11 and cerebellar WM hyperintensities: 3/11). The BG is also often concerned (lenticular nuclei [LN]: 9/11) as the thalami (6/11).…”

Human African trypanosomiasis cases diagnosed in non-endemic countries (2011–2020)

“…During 2011-2020, 11 additional papers were published (5 in 2012, 1 in 2013, 2 in 2014 and 3 in 2016) concerning cases diagnosed during 2000-2010; therefore they were not considered for this paper [28][29][30][31][32][33][34][35][36][37][38][39].…”