title: [Human African trypanosomiasis from Trypanosoma brucei gambiense with inoculation chancre in a French expatriate].
abstract: This report describes a case of West African trypanosomiasis involving a Caucasian Frenchman living in Conackry, Guinea. The patient presented with fever and two skin chancres highly suggestive of very early lymphatic stage trypanosomiasis. Examination of peripheral blood smears confirmed diagnosis of west African trypanosomiasis. Further immunologic evaluation showed elevated serum levels of specific IgM and IgG. The patient was treated by intravenous perfusion Pentacarinat at dose 5 x 4 mg/kg/day over a period of ten days. Clinical signs improved and parisitemia decreased within two days. The remarkable feature of this case was the presence of two chancres in association with the Gambian form. Since this finding allowed early diagnosis, treatment was well-tolerated and effective. This case also demonstrates the important role of travellers or expatriate workers as sentinels for emerging/re-emerging infectious diseases.
authors.affiliation: Service de Médecine Interne et des Maladies Tropicales, Hôpital Saint André, 1, rue Jean Burguet, F-33071 Bordeaux. Denis.Malvy@crl.u-bordeaux2.fr
authors.forename: D
authors.initials: D
authors.lastname: Malvy
authors.forename: F
authors.initials: F
authors.lastname: Djossou
authors.forename: F X
authors.initials: FX
authors.lastname: Weill
authors.forename: P
authors.initials: P
authors.lastname: Chapuis
authors.forename: M
authors.initials: M
authors.lastname: Longy-Boursier
authors.forename: M
authors.initials: M
authors.lastname: Le Bras
mesh_terms: D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D004890:Erythema / Q000469:parasitology*; D005334:Fever; D005602:France / Q000208:ethnology; D016701:Guinea; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D018512:Parasitemia; D010419:Pentamidine / Q000008:administration & dosage / Q000627:therapeutic use; D014344:Trypanocidal Agents / Q000627:therapeutic use; D014347:Trypanosoma brucei gambiense; D014353:Trypanosomiasis, African / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D014344:Trypanocidal Agents; D010419:Pentamidine