• 1.

    WHO, 2013. Control and Surveillance of Human African Trypanosomiasis. Geneva, Switzerland: World Health Organization.

  • 2.

    Chappuis F, Loutan L, Simarro P, Lejon V, Büscher P, 2005. Options for field diagnosis of human African trypanosomiasis. Clin Microbiol Rev 18: 133146.

    • Search Google Scholar
    • Export Citation
  • 3.

    Büscher P, Mumba Ngoyi D, Kaboré J, Lejon V, Robays J, Jamonneau V, Bebronne N, Van der Veken W, Biéler S, 2009. Improved models of mini anion exchange centrifugation technique (mAECT) and modified single centrifugation (MSC) for sleeping sickness diagnosis and staging. PLoS Negl Trop Dis 3: e471.

    • Search Google Scholar
    • Export Citation
  • 4.

    Franco JR, Cecchi G, Priotto G, Paone M, Diarra A, Grout L, Simarro PP, Zhao W, Argaw D, 2018. Monitoring the elimination of human African trypanosomiasis: update to 2016. PLoS Negl Trop Dis 12: e0006890.

    • Search Google Scholar
    • Export Citation
  • 5.

    Robays J, Ebeja Kadima A, Lutumba P, Miaka mia Bilenge C, Kande Betu Ku Mesu V, De Deken R, Makabuza J, Deguerry M, Van der Stuyft P, Boelaert M, 2004. Human African trypanosomiasis amongst urban residents in Kinshasa: a case-control study. Trop Med Int Heal 9: 869875.

    • Search Google Scholar
    • Export Citation
  • 6.

    Simon F, Mura M, Pagès F, Morand G, Truc P, Louis F, Gautret P, 2012. Urban transmission of human African trypanosomiasis, Gabon. Emerg Infect Dis 18: 165167.

    • Search Google Scholar
    • Export Citation
  • 7.

    Leder K et al. GeoSentinel Surveillance Network, 2013. GEosentinel surveillance of illness in returned travelers, 2007–2011. Ann Intern Med 158: 456468.

    • Search Google Scholar
    • Export Citation
  • 8.

    Simarro PP, Franco JR, Cecchi G, Paone M, Diarra A, Ruiz Postigo JA, Jannin JG, 2012. Human African trypanosomiasis in non-endemic countries (2000–2010). J Travel Med 19: 4453.

    • Search Google Scholar
    • Export Citation
  • 9.

    Brun R, Blum J, Chappuis F, Burri C, 2010. Human African trypanosomiasis. Lancet 375: 148159.

  • 10.

    Büscher P, Cecchi G, Jamonneau V, Priotto G, 2017. Human African trypanosomiasis. Lancet 390: 23972409.

  • 11.

    Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, Keystone JS, Pandey P, Cetron MS, 2006. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354: 119130.

    • Search Google Scholar
    • Export Citation
  • 12.

    Mukendi D et al. 2017. Clinical spectrum, etiology, and outcome of neurological disorders in the rural hospital of Mosango, the Democratic Republic of Congo. Am J Trop Med Hyg 97: 14541460.

    • Search Google Scholar
    • Export Citation
  • 13.

    Rajkumar SV, 2011. Multiple myeloma: 2012 update on diagnosis, risk-stratification, and management. Am J Hematol 87: 7888.

  • 14.

    Sudarshi D et al. 2014. Human African trypanosomiasis presenting at least 29 years after infection—what can this teach us about the pathogenesis and control of this neglected tropical disease? PLoS Negl Trop Dis 8: e3349.

    • Search Google Scholar
    • Export Citation
  • 15.

    Pays E, 2005. Regulation of antigen gene expression in Trypanosoma brucei. Trends Parasitol 21: 517520.

  • 16.

    Meda HA, Doua F, Laveissière C, Miezan TW, Gaens E, Brattegaard K, de Muynck A, De Cock KM, 1995. Human immunodeficiency virus infection and human African trypanosomiasis: a case-control study in Côte d’Ivoire. Trans R Soc Trop Med Hyg 89: 639643.

    • Search Google Scholar
    • Export Citation
  • 17.

    Perez CJ, Lymbery AJ, Thompson RCA, 2015. Reactivation of Chagas disease: implications for global health. Trends Parasitol 31: 595603.

  • 18.

    Diro E, Lynen L, Ritmeijer K, Boelaert M, Hailu A, van Griensven J, 2014. Visceral leishmaniasis and HIV coinfection in east Africa. PLoS Negl Trop Dis 8: e2869.

    • Search Google Scholar
    • Export Citation
  • 19.

    Sartori AMC, Lopes MH, Caramelli B, Duarte MIS, Pinto PL, Neto V, Amato Shikanai-Yasuda M, 1995. Simultaneous occurrence of acute myocarditis and reactivated Chagas’ disease in a patient with AIDS. Clin Infect Dis 21: 12971299.

    • Search Google Scholar
    • Export Citation
  • 20.

    Cordova E, Boschi A, Ambrosioni J, Cudos C, Corti M, 2008. Reactivation of Chagas disease with central nervous system involvement in HIV-infected patients in Argentina, 1992–2007. Int J Infect Dis 12: 587592.

    • Search Google Scholar
    • Export Citation
  • 21.

    Truc P, Lejon V, Magnus E, Jamonneau V, Nangouma A, Verloo D, Penchenier L, Büscher P, 2002. Evaluation of the micro-CATT, CATT/Trypanosoma brucei gambiense, and LATEX/T b gambiense methods for serodiagnosis and surveillance of human African trypanosomiasis in west and central Africa. Bull World Health Organ 80: 882886.

    • Search Google Scholar
    • Export Citation
  • 22.

    Simarro PP, Ruiz JA, Franco JR, Josenando T, 2002. Attitude towards CATT-positive individuals without parasitological confirmation in the African trypanosomiasis (T.b. gambiense) focus of Quiçama (Angola). Trop Med Int Health 4: 858861.

    • Search Google Scholar
    • Export Citation
  • 23.

    Boelaert M et al. 2017. A phase III diagnostic accuracy study of a rapid diagnostic test for diagnosis of second stage human African trypanosomiasis in the Democratic Republic of the Congo. EBioMedicine 27: 1117.

    • Search Google Scholar
    • Export Citation
  • 24.

    Lejon V, Boelaert M, Jannin J, Moore A, Büscher P, 2003. The challenge of Trypanosoma brucei gambiense sleeping sickness diagnosis outside Africa. Lancet Infect Dis 3: 804808.

    • Search Google Scholar
    • Export Citation
  • 25.

    Garcia A, Jamonneau V, Magnus E, Laveissière C, Lejon V, N’guessan P, N’Dri L, Van Meirvenne N, Büscher P, 2008. Follow-up of card agglutination trypanosomiasis test (CATT) positive but apparently aparasitaemic individuals in Côte d’Ivoire: evidence for a complex and heterogeneous population. Trop Med Int Health 5: 786793.

    • Search Google Scholar
    • Export Citation
  • 26.

    Nkemgu-Njinkeng J, Rosenkranz V, Wink M, Steverding D, 2002. Antitrypanosomal activities of proteasome inhibitors. Antimicrob Agents Chemother 46: 20382040.

    • Search Google Scholar
    • Export Citation
  • 27.

    Steverding D, Wang X, 2009. Trypanocidal activity of the proteasome inhibitor and anti-cancer drug bortezomib. Parasit Vectors 2: 29.

  • 28.

    Barrett SV, Barrett MP, 2000. Anti-sleeping sickness drugs and cancer chemotherapy. Parasitol Today 16: 79.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Case Report: Trypanosoma brucei Gambiense Human African Trypanosomiasis as the Cause of Fever in an Inpatient with Multiple Myeloma and HIV-1 Coinfection

View More View Less
  • 1 Faculty of Medicine, University of British Columbia, Vancouver, Canada;
  • | 2 J.D. MacLean Centre for Tropical Diseases, Montreal, Canada;
  • | 3 Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, Montreal, Canada;
  • | 4 National Reference Centre for Parasitology, Montreal, Canada
Restricted access

We report the case of a 64-year-old woman found to have urban-acquired Trypanosoma brucei (T.b.) gambiense human African trypanosomiasis (HAT) as the cause of sustained fever starting 9 months after returning to Canada from Democratic Republic of the Congo, in the context of concomitant multiple myeloma and HIV-1 coinfection. Approaches for the management of both clinical stages of T.b. gambiense HAT are well defined for endemic settings using current diagnostics and treatments. However, few data inform the diagnosis and management of patients with bone marrow suppression from active malignancy, recent anticancer therapy, or HIV coinfection. We discuss the implications of immunosuppression for diagnosis and management of T.b. gambiense HAT.

Author Notes

Address correspondence to Carl Boodman, Division of Infectious Diseases, Department of Medical Microbiology, J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, 1001 Décarie Blvd., Rm. EM3.3242, Montreal, Québec H4A 3J1, Canada. E-mail: carl.boodman@alumni.ubc.ca

Authors’ addresses: Carl Boodman, Department of Medicine, University of British Columbia, Vancouver, Canada, and J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Canada, E-mail: carl.boodman@alumni.ubc.ca. Michael Libman and Cedric P. Yansouni, J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Canada, and Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, Montreal, Canada, E-mails: michael.libman@mcgill.ca and cedric.yansouni@mcgill.ca. Momar Ndao, J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Canada, Department of Medicine, Research Institute of the McGill University Health Centre, Montreal, Canada, and National Reference Centre for Parasitology, Montreal, Canada, E-mail: momar.ndao@mcgill.ca.

Save