Sleeping sickness


  1. Bite of tsetse fly

  2. Erythema, swelling, chancre at bite site

  3. Later fever, myalgia - at this stage treat with Pentamidine

  4. CNS involvement - lethargy, sleepy, comatose - treat with melarsoprol / suramin

  5. Serology n/a for East African 🙁 but available for west African trypanosomiasis

  6. Most important inv is CT Brain f/b LP - determine stage of disease - determines treatment

  7. Usually blood film itself will have trypomastigotes - initial test for diagnosis

P.S: can someone be kind enough to list which are the countries in West Africa and East Africa please!