[Psychiatric presentation of human African trypanosomiasis: overview of diagnostic pitfalls, interest of difluoromethylornithine treatment and contribution of magnetic resonance imaging].
We report a case of a western African man, residing in France for 4 years, who developed human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense. Diagnosis was made at a late stage of the disease. The disease was misdiagnosed and untreated for several years because the clinical presentation was limited to psychiatric disorders and biological confirmation was difficult. Polysomnographic recordings demonstrated typical alterations of HAT. Difluoromethylornithine was effective in this late stage of the disease. Magnetic resonance imaging showed brain edema with demyelination and associated brain atrophy and abnormal signals in the brainstem and thalamus, both implied in sleep-wake cycle.
Bédat-Millet
A L
AL
Service de Neurologie, Hôpital Lariboisière, France.
Charpentier
S
S
Monge-Strauss
M F
MF
Woimant
F
F
D000328:Adult; D000818:Animals; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D000518:Eflornithine / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008590:Meningoencephalitis / Q000175:diagnosis* / Q000188:drug therapy; D019965:Neurocognitive Disorders / Q000175:diagnosis* / Q000188:drug therapy; D014344:Trypanocidal Agents / Q000627:therapeutic use; D014347:Trypanosoma brucei gambiense; D014353:Trypanosomiasis, African / Q000175:diagnosis* / Q000188:drug therapy
D014344:Trypanocidal Agents; D000518:Eflornithine