Clinical, infection by T.b. gambiense

Any bite from a tsetse fly, whether infected or not, produces a local reaction. When the bite is infected, a small local wound can appear after 1 or more weeks, in general after 5-15 days (trypanosomal chancre or sore or trypanoma). This often remains unnoticed in the local population, though it can sometimes reach quite substantial dimensions (2-5 cm). In infected Europeans, it is described at a frequency of 25-40%. It involves a central blister or ulcer surrounded by red infiltrated skin. The lesion is not really painful. When it has healed after 1-3l weeks a depigmented scar can remain. The infection develops slowly if there is no medical intervention. The patient’s condition gradually deteriorates, ultimately leading to his/her death after six months or more. There are two quite artificially separated stages: a preliminary haemato­lymphatic stage and a second stage with symptoms of meningoencephalitis. The boundary between these two stages is determined by the findings in the cerebrospinal fluid. The distinction is important for treatment. Asymptomatic human carriers are rare.

Category: Medicine Notes