Prof Lucille Blumberg, GeoSentinel site director Johannesburg, has reported a confirmed case of East African trypanosomiasis (EAT) in a 23-year-old student from Holland who visited a number of areas in Uganda in September 2019. Transmission is most likely to have occurred during a visit to Murchison Falls, although there was no report of tsetse flies or of having been bitten during the trip. The man developed fever and a submandibular lesion, a week after his return to South Africa, where he is currently on a study assignment. Initially, a diagnosis of EAT was not considered and he underwent a minor surgical procedure to drain the lesion. The diagnosis was made when a peripheral blood smear was reviewed to determine the cause of a profound thrombocytopenia, with no evidence of malaria. The patient is being managed in a critical care unit due to the development of ARDS, hepatic and renal dysfunction, and intermittent confusion. Initial doses of suramin have been administered. CSF will be examined once the peripheral parasitaemia has cleared. Historically, the north-west of Uganda has West African trypanosomiasis, although there have been cases of EAT in the Murchison falls region in recent years, which is slightly south of the area with established West African disease. This is one of a small number of reported cases that were potentially associated with travel to this popular national park.
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Prof Lucille Blumberg, GeoSentinel site director Johannesburg, has reported a confirmed case of East African trypanosomiasis (EAT) in a 23-year-old student from Holland who visited a number of areas in Uganda in September 2019. Transmission is most likely to have occurred during a visit to Murchison Falls, although there was no report of tsetse flies or of having been bitten during the trip. The man developed fever and a submandibular lesion, a week after his return to South Africa, where he is currently on a study assignment. Initially, a diagnosis of EAT was not considered and he underwent a minor surgical procedure to drain the lesion. The diagnosis was made when a peripheral blood smear was reviewed to determine the cause of a profound thrombocytopenia, with no evidence of malaria. The patient is being managed in a critical care unit due to the development of ARDS, hepatic and renal dysfunction, and intermittent confusion. Initial doses of suramin have been administered. CSF will be examined once the peripheral parasitaemia has cleared. Historically, the north-west of Uganda has West African trypanosomiasis, although there have been cases of EAT in the Murchison falls region in recent years, which is slightly south of the area with established West African disease. This is one of a small number of reported cases that were potentially associated with travel to this popular national park.