Sleeping sickness is caused by trypanosoma brucei which is a flagellated trypomastigote.
Tsetse fly is the vector of transmission of the trypanosoma brucei infection. Physical protection is used to avoid bites from tsetse fly.
The characteristic of sleeping sickness may include chancre or ulcer at the site of bite of tsetse fly.
Patient may present with cyclical fever. There will also be enlargement of the posterior cervical lymph node ( Winterbottom’s sign).
Chronic case may be manifested in demyelinating encephalitis. Demyelinating encephalitis may present with coma and death.
There are two different strains of trypanosoma brucei which include rhodesiense ( the reservoirs are domestic or wild animals) and gambiense.
The trypomastigote can be detected in the cerebrospinal fluid, blood or lymph node aspiration. The IgM antibody levels are elevated.
The antigenic variation of the surface of the glycoproteins of trypanosoma brucei may lead to an effective evasion of the humoral human response and the cyclic nature of the fever.
Trypanosoma brucei infection may be spread to central nervous system via the blood. In this case melarsoprol is used to treat the condition. Generally acute cases can be treated with suramin and pentamidine.
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