[Human African trypanosomiasis: report of three cases]

Prolonged fever is an important cause of morbidity in pediatric practice, especially in tropical areas. It is above all a problem of etiological diagnosis given the vast number of etiologies. In sub-Saharan Africa, practitioners more often focus on bacterial infections and malaria at the expense of other infectious diseases such as human African trypanosomiasis (HAT), most often leading to overuse of antibiotics and antimalarials. A dramatic resurgence of HAT, also called sleeping sickness, has been reported during the last few decades in large areas of Central Africa. Furthermore, with the development of air transport, cases of children infected during a trip to Africa can be exported outside endemic areas, making diagnosis even more difficult. This parasitic infection causes a protracted, often initially unrecognized, illness with episodes of fever, headache, and malaise, accompanied by progressive lymphadenopathy, before the development of a progressive meningoencephalitis. These three case reports aim to remind practitioners of clinical and biological signs suggestive of HAT diagnosis in children living in endemic areas or having stayed there during the months prior to visiting the doctor. The prognosis is largely dependent on the precocity of diagnosis and therapeutic support.