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