Transverse myelitis due to trypanosomiasis in a middle aged Tanzanian man

We report the case of a middle aged Tanzanian man who developed a spinal cord syndrome over 6 weeks, along with a mild encephalopathy. Investigations ruled out the usual major causes of such a syndrome in our setting in northern Tanzania. Examination of his cerebrospinal fluid revealed trypanosomes,...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2006-05, Vol.77 (5), p.684-685
Main Authors: Kibiki, G S, Murphy, D K
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Animals
Biological and medical sciences
cerebrospinal fluid
Clinical outcomes
CSF
Developing Countries
Drug Therapy, Combination
Follow-Up Studies
Guillain-Barre syndrome
Hematologic and hematopoietic diseases
HIV
Human immunodeficiency virus
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Male
Medical sciences
Melarsoprol - therapeutic use
Metabolism
Middle age
Middle Aged
Myelitis, Transverse - diagnosis
Myelitis, Transverse - drug therapy
Myelitis, Transverse - etiology
Neurologic Examination - drug effects
Neurology
Proprioception
Proteins
Protozoa
Radiculopathy - diagnosis
Radiculopathy - drug therapy
Radiculopathy - etiology
Serology
Short Report
Spinal cord
Spinal Cord Compression - diagnosis
Spinal Cord Compression - drug therapy
Spinal Cord Compression - etiology
Substance abuse treatment
Suramin - therapeutic use
T brucei
Tanzania
transverse myelitis
Tropical diseases
Trypanocidal Agents - therapeutic use
Trypanosoma
Trypanosoma brucei brucei
trypanosomiasis
Trypanosomiasis, African - complications
Trypanosomiasis, African - diagnosis
Trypanosomiasis, African - drug therapy
Tuberculosis
Vascular diseases and vascular malformations of the nervous system
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Summary:We report the case of a middle aged Tanzanian man who developed a spinal cord syndrome over 6 weeks, along with a mild encephalopathy. Investigations ruled out the usual major causes of such a syndrome in our setting in northern Tanzania. Examination of his cerebrospinal fluid revealed trypanosomes, and he made a slow but dramatic improvement after a full course of suramine and melarsoprol. We postulate that he had a transverse myelitis due to African trypanosomiasis, a rare and barely recognised cause.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.2005.079533