Answer: Human African Trypanosoma. A molecular study using PCR with a blood sample confirmed the presence of Trypanosoma brucei gambiense in the blood. Examination of cerebral spinal fluid showed increased protein levels (161 mg/dl) and lymphocyte counts (112 cells/μl), indicating the involvement of the central nervous system. Eosinophil counts were not increased in the peripheral blood. The patient was referred to Jiangsu Province Institute of Parasitic Diseases and treated with eflornithine. His condition was controlled after treatment.
Human African trypanosomiasis, or sleeping disease, is caused by Trypanosoma brucei, a type of parasite that infects humans through the bite of the tsetse fly (1). There are two subtypes that infect humans, Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense. Trypanosoma brucei gambiense causes over 98% of reported cases. African trypanosomiasis is curable with medication but is fatal if left untreated (2). While the disease is endemic in sub-Saharan African countries and had not been reported in China previously, with increasing international exchanges and labor export service, sporadic cases caused by parasites imported from Africa may occur in China. Special attention to and early recognition of these infectious diseases caused by parasites imported from abroad are critical for proper treatment and prevention of serious consequences.
(See page 2631 in this issue [doi:10.1128/JCM.03285-14] for photo quiz case presentation.)
ACKNOWLEDGMENTS
The work was supported by a scholarship from the Department of Health, Shanghai, China, to X.H. (XYQ2011007).
X.H. collected and verified patient information, analyzed and interpreted data, and wrote the manuscript. Y.S. analyzed data, performed the blood film examination, and verified patient information. X.X., L.X., B.M., and L.W. diagnosed and treated the patient. H.W. and Z.N. performed PCR. M.H. performed the pathology examination. D.Z. verified the blood film. J.W. diagnosed the patient. A.D. and J.Y. interpreted data and critically reviewed the manuscript.
We declare no competing financial interests.
REFERENCES
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