African trypanosomiasis diagnosis by peripheral blood

Case: A 49-year-old Spanish woman presented immediately on return to Spain from a 2-week visit to Tanzania with malaise, fatigue, arthralgia, and high fever (39°C). She had a medical history of dengue 4 years ago. Physical examination revealed signs of an arthropod bite on the neck with an evident chancre. Hepatosplenomegaly and lymphadenopathy were absent. Blood analysis showed leukopenia (2.3 × 10⁹/L) and thrombocytopenia (55 × 10⁹/L), low prothrombin index expressed as a percentage (66%), increased lactate dehydrogenase (622 IU/L; normal, 250-450 IU/L), and hepatic transaminase values (aspartate aminotransferase: 159 IU/L; normal, 5-40 IU/L; alanine aminotransferase: 207 IU/L; normal, 5-40 IU/L). The peripheral blood film was diagnostic for trypanosome infection, showing the presence of extracellular flagellated parasites.

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Human African trypanosomiasis diagnosis by peripheral blood smear review in a Spanish traveler

Source: Blood journal