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Morphologic types of Trypanosomes and description
- Amastigote - rounded with central flagellum
- Promastigote - elongated with posterior flagellum
- Epimastigote - elongated with central flagellum
- Trypomastigote - elongated with anterior flagellum
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Which morphologic type is found in African sleeping sickness?
Typomastigotes - bloodstream, lymphatics, CSF
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Which morphologic types are found in Chagas' disease?
- Trypomastigotes in bloodstream
- Amastigotes intracellularly (cardiac muscle)
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What trypanosome causes Gambian/West African Sleeping Sickness?
Trypanosoma brucei gambiense
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Gambian African Sleeping Sickness - How do you get it?
Bite from infected tsetse fly
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Winterbottom's sign
- Enlargement of the posterior cervical lymph nodes
- Seen in Gambian African Sleeping Sickness
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Kerandel's sign
- Severe pain following any pressure on palms of the hands or over ulnar nerve
- Seen in Gambian African Sleeping Sickness
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Gambian Trypanosomiasis - Presentation?
- Ulceration at bite site (trypanosomal chancre)
- Febrile attacks
- Winterbottom's sign
- Increasing apathy, fatigue
- Kerandel's sign
- Progressive meningoencephalitis
- Coma
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Gambian Trypanosomiasis - Diagnosis?
ID of trypanosomes in blood, lymph, or CSF
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How are trypanosomes able to evade host defenses?
Constantly changing surface antigens
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Where do tsetse flies live?
Banks of shaded streams
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Gambian Trypanosomiasis - Treatment?
Pentamidine and Melarsoprol
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What causes Trypanosomiasis in Eastern and Central Africa?
Trypanosoma brucei rhodesiense
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Rhodesian Trypanosomiasis - Presentation?
- More rapidly progressive (frequently die before menigoencephalitic signs)
- Rigor and fever
- Rapid weight loss
- Early CNS involvement
- Little to no lymphadenopathy
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Rhodesian Trypanosomiasis - Differences?
- More virulent
- Number of animal resevoirs
- Tsetses breed in lightly covered bush areas
- Untreated patients die within 1 year
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What causes Chagas' disease?
Trypanosoma cruzi
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American trypanosomiasis
Chagas' disease
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American trypanosomiasis - How do you get it?
Reduviid bug bites get contaminated with its own feces, which contains the trypanosomes
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American trypanosomiasis - Presentation?
- Erythematous indurated area at site of infection (Chagoma)
- Regional lymphadenopathy
- Romana's sign
- Malaise, chills, fever, myalgias
- Hepatospenomegaly, anasarca
- Megacolon, megaesophagus
- Meningoencephalitis
- Chagastic cardiopathy
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Romana's Sign
Unilateral edema of both the upper and lower eyelid and conjunctivitis
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American trypanosomiasis - Diagnosis?
- Blood smear
- Xenodiagnosis (testing reduviid bugs that have fed only on patient)
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American trypanosomiasis - Treatment?
Nitrofurfurylidine derivative nifurtimox (Lampit aka Bayer 2502)
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T. brucei (rhodesiense or gambiense)
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