Cutaneous manifestations of African trypanosomiasis

McGovern, T. W.

doi:10.1001/archderm.131.10.1178

Cited by 13 publications

(10 citation statements)

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“…In Guinea, asymptomatic or latent infections were found to have consistently high titres in CATT/ T. b. gambiense and to be positive in the immune trypanolysis test, although no parasites could be detected in blood or lymph node fluid during a 2-year follow-up period [14] . This observation is in line with the fact that trypanosomes can survive in the extravascular spaces of diverse organs such as the heart, the central nervous system, and the skin 15 , 16 , 17 . Experimental infections in animals confirmed that parasites may be undetectable in the blood but hidden in different organs and tissues 18 , 19 , 20 , 21 , including the skin, from where they can be ingested by tsetse flies 22 , 23 .…”

Section: Human Reservoirsupporting

confidence: 77%

Do Cryptic Reservoirs Threaten Gambiense-Sleeping Sickness Elimination?

Büscher

Bart

Boelaert

et al. 2018

Trends in Parasitology

152

165

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Trypanosoma brucei gambiense causes human African trypanosomiasis (HAT). Between 1990 and 2015, almost 440 000 cases were reported. Large-scale screening of populations at risk, drug donations, and efforts by national and international stakeholders have brought the epidemic under control with <2200 cases in 2016. The World Health Organization (WHO) has set the goals of gambiense-HAT elimination as a public health problem for 2020, and of interruption of transmission to humans for 2030. Latent human infections and possible animal reservoirs may challenge these goals. It remains largely unknown whether, and to what extend, they have an impact on gambiense-HAT transmission. We argue that a better understanding of the contribution of human and putative animal reservoirs to gambiense-HAT epidemiology is mandatory to inform elimination strategies.

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Section: Human Reservoirsupporting

confidence: 77%

Do Cryptic Reservoirs Threaten Gambiense-Sleeping Sickness Elimination?

Büscher

Bart

Boelaert

et al. 2018

Trends in Parasitology

152

165

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“…Detection of trypanosomes in the skin is not well documented, although there are descriptions of cutaneous symptoms associated with African trypanosomiasis and distinct ‘trypanid’ skin lesions ( McGovern et al, 1995 ). Imaging data from mouse models of infection suggest that trypanosomes sequester to major organs such as the spleen, liver and brain ( Blum et al, 2008 ; Kennedy, 2004 ) and recent evidence has demonstrated trypanosomes in extravascular adipose tissue ( Trindade et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

The skin is a significant but overlooked anatomical reservoir for vector-borne African trypanosomes

Capewell

Travaillé

Marchesi

et al. 2016

eLife

251

288

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The role of mammalian skin in harbouring and transmitting arthropod-borne protozoan parasites has been overlooked for decades as these pathogens have been regarded primarily as blood-dwelling organisms. Intriguingly, infections with low or undetected blood parasites are common, particularly in the case of Human African Trypanosomiasis caused by Trypanosoma brucei gambiense. We hypothesise, therefore, the skin represents an anatomic reservoir of infection. Here we definitively show that substantial quantities of trypanosomes exist within the skin following experimental infection, which can be transmitted to the tsetse vector, even in the absence of detectable parasitaemia. Importantly, we demonstrate the presence of extravascular parasites in human skin biopsies from undiagnosed individuals. The identification of this novel reservoir requires a re-evaluation of current diagnostic methods and control policies. More broadly, our results indicate that transmission is a key evolutionary force driving parasite extravasation that could further result in tissue invasion-dependent pathology.DOI: http://dx.doi.org/10.7554/eLife.17716.001

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“…The usefulness of touch preparation for rapid diagnosis of invasive cutaneous infections has been reported in only 6 cases ( Table I ). 6 , 7 , 8 , 9 , 10 However, 3 of the reports (including the current case) were from residents trained at the same hospital program in this simple technique with reproducible success. Multiple stains can highlight fungal organisms including but not limited to potassium hydroxide, periodic acid–Schiff, Gomori methenamine silver, and even Gram stain.…”

Section: Discussionmentioning

confidence: 89%