African trypanosomiasis in an American hunter in East Africa

An American citizen acquired African trypanosomiasis while on a hunting safari in Sudan, East Africa. His travel history and rapid onset of symptoms, including fever, chills, headache, lethargy, and weight loss, were suggestive of Trypanosoma brucei rhodesiense infection, and trypanosomes were demonstrated in routine blood smears and buffy-coat preparations. Despite the presence of headaches, nuchal rigidity, and CSF pleocytosis, he was treated for non-CNS African trypanosomiasis, based on a normal CSF IgM level. This case report, along with a review of previously reported cases of imported African trypanosomiasis, illustrates the importance of clinical consideration of this rare, but often misdiagnosed, tropical illness in febrile patients returning from Africa.