Severe African Trypanosomiasis with Spurious Hypoglycemia

Nieman, Roger E.; Kelly, John J.; Waskin, Hetty

doi:10.1093/infdis/159.2.360

Cited by 9 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hypoglycaemia is the most notable clinical feature of this case. Hypoglycaemia is part of the classical presentation of trypanosomosis; it has been reported in several species, as in buffaloes [ 19 ], in buffalo calves [ 20 ], in goats [ 24 ], in camels [ 27 ], in a tiger [ 34 ], in a dog [ 15 ] and in a human [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Refractory hypoglycaemia in a dog infected withTrypanosoma congolense

Deschamps¹,

Desquesnes²,

Dorso³

et al. 2016

Parasite

View full text Add to dashboard Cite

A 20 kg German shepherd dog was presented to a French veterinary teaching hospital for seizures and hyperthermia. The dog had returned 1 month previously from a six-month stay in Senegal and sub-Saharan Africa. Biochemistry and haematology showed severe hypoglycaemia (0.12 g/L), anaemia and thrombocytopenia. Despite administration of large amounts of glucose (30 mL of 30% glucose IV and 10 mL of 70% sucrose by gavage tube hourly), 26 consecutive blood glucose measurements were below 0.25 g/L (except one). Routine cytological examination of blood smears revealed numerous free extracytoplasmic protozoa consistent with Trypanosoma congolense. PCR confirmed a Trypanosoma congolense forest-type infection. Treatment consisted of six injections of pentamidine at 48-hour intervals. Trypanosomes had disappeared from the blood smears four days following the first injection. Clinical improvement was correlated with the normalization of laboratory values. The infection relapsed twice and the dog was treated again; clinical signs and parasites disappeared and the dog was considered cured; however, 6 years after this incident, serological examination by ELISA T. congolense was positive. The status of this dog (infected or non-infected) remains unclear. Hypoglycaemia was the most notable clinical feature in this case. It was spectacular in its severity and in its refractory nature; glucose administration seemed only to feed the trypanosomes, indicating that treatment of hypoglycaemia may in fact have been detrimental.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In a case reported in the United States to CDC internal records, a diabetic patient with African trypanosomosis required less insulin during the acute phase of his illness (Ackley A., personal communication, quoted by Nieman [ 12 , 25 ]).…”

Section: Discussionmentioning

confidence: 99%

Refractory hypoglycaemia in a dog infected withTrypanosoma congolense

Deschamps¹,

Desquesnes²,

Dorso³

et al. 2016

Parasite

View full text Add to dashboard Cite

show abstract

“…Although HAT is persistently endemic in the African continent, and although there has been a recent resurgence in infection [4], only a small number of cases (!15) have been reported in international travelers during the past 15 years. Most of these infected travelers had returned from short trips to national parks in Africa [5][6][7][8][9][10][11][12][13][14][15]. However, from January through March 2001, TropNetEurop published warnings regarding a cluster of 6 patients (5 European travelers and 1 South African tourist) who acquired an acute form of sleeping sickness after a trip to Tanzania [16].…”

mentioning

confidence: 99%

African Sleeping Sickness in Tourists Returning from Tanzania: The First 2 Italian Cases from a Small Outbreak among European Travelers

Ripamonti

Massari

Arici

et al. 2002

Clinical Infectious Diseases

View full text Add to dashboard Cite

A recent cluster of cases of African trypanosomiasis in humans (HAT) has been reported in tourists (most of whom were European) returning from Tanzania; we describe the first 2 patients (both of whom were Italian travelers) with HAT, who have been treated successfully. Because neither vaccine nor drug prophylaxis is currently recommended and/or available for persons traveling to areas of endemicity, physicians should be alerted about this uncommon but potentially life-threatening disease.

show abstract

“…The development of the diamidines arose from the observations that advanced (animal) trypanosomiasis is often associated with hypoglycaemia [5,6] and trypanosomes metabolise glucose at a phenomenal rate. This suggested that the chemical induction of hypoglycaemia might be deleterious to trypanosomes in the bloodstream.…”

Section: Diamidinesmentioning

confidence: 99%

“…and a therapeutic index of 30-closely followed by propamidine (4) and pentamidine, which displayed a slightly lower therapeutic index of 15. To appreciate the enormous advance this signified, these numbers need to be compared to the dramatically higher minimum curative doses for the aromatic arsenicals then in use: 1000 mg/kg for tryparsamidine (5) or 250 mg/kg for atoxyl (6), each with a therapeutic index of just two [12]! As stilbamidine appeared to induce adverse neurological sequelae in early clinical trials [13], it was abandoned and pentamidine became the drug of choice for early stage HAT, especially of the gambiense variety.…”

Section: Diamidinesmentioning

confidence: 99%

The Drugs of Sleeping Sickness: Their Mechanisms of Action and Resistance, and a Brief History

Koning

2020

TropicalMed

View full text Add to dashboard Cite

With the incidence of sleeping sickness in decline and genuine progress being made towards the WHO goal of eliminating sleeping sickness as a major public health concern, this is a good moment to evaluate the drugs that ‘got the job done’: their development, their limitations and the resistance that the parasites developed against them. This retrospective looks back on the remarkable story of chemotherapy against trypanosomiasis, a story that goes back to the very origins and conception of chemotherapy in the first years of the 20 century and is still not finished today.

show abstract

Severe African Trypanosomiasis with Spurious Hypoglycemia

Cited by 9 publications

References 0 publications

Refractory hypoglycaemia in a dog infected withTrypanosoma congolense

Refractory hypoglycaemia in a dog infected withTrypanosoma congolense

African Sleeping Sickness in Tourists Returning from Tanzania: The First 2 Italian Cases from a Small Outbreak among European Travelers

The Drugs of Sleeping Sickness: Their Mechanisms of Action and Resistance, and a Brief History

Contact Info

Product

Resources

About