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African trypanosomiasis in a British soldier
A M Croft1, C J Jackson, H M Friend
1Headquarters Fifth Division, Copthorne Barracks, Shrewsbury, Shropshire SY3 8LZ ashley.croft810@land.mod.uk
Journal of the Royal Army Medical Corps
|February 14, 2007
Summary
A British soldier contracted sleeping sickness in Malawi, presenting with early signs and severe organ failure. Prompt treatment with suramin led to a full recovery, highlighting the need for medical preparedness.
Area of Science:
- Tropical Medicine
- Parasitology
- Infectious Diseases
Background:
- Human African trypanosomiasis (HAT), or sleeping sickness, is a fatal parasitic disease transmitted by tsetse flies.
- Microscopy is the gold standard for diagnosing HAT, with over 300,000 new cases and 100,000 deaths annually.
Observation:
- A British soldier in Malawi presented with early sleeping sickness symptoms, including a chancre, lymphadenopathy, erythema, and fever.
- Despite no history of an insect bite, trypanosomes were detected in his blood, progressing to Stage One *Trypanosoma brucei rhodesiense* infection with multi-organ failure.
Findings:
- The soldier experienced renal and liver failure, pancytopenia, and heart block.
- Intravenous suramin treatment resulted in a complete recovery over five months.
Implications:
- Medical officers in endemic areas must recognize early *T. b. rhodesiense* symptoms and ensure access to microscopy.
- Immediate transfer to specialized centers for treatment with suramin, pentamidine, or melarsoprol is crucial for confirmed HAT cases.
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