African Trypanosomiasis

Description

MBBS Tropical Medicine Mind Map on African Trypanosomiasis, created by Amirul Aiman on 04/07/2018.
Amirul Aiman
Mind Map by Amirul Aiman, updated more than 1 year ago
Amirul Aiman
Created by Amirul Aiman over 5 years ago
10
1

Resource summary

African Trypanosomiasis
  1. Summary
    1. Sleeping sickness
      1. T brucei group
        1. Gambiense TbG
          1. West + Central
            1. Gradual
              1. Human- Human
            2. rhodesiense TbR
              1. East + South
                1. Rapid
                  1. Reservoir
                    1. Game
                      1. Cattle
                2. Vector (transmission)
                  1. Tsetse fly
                    1. Painful bite
                      1. Rural woodlands + forest
                      2. Rarely
                        1. Bloodborne
                          1. Congenital
                        2. Locality
                          1. Sub Saharan
                            1. DR of Congo
                              1. South Sudan
                                1. Central African Rebuplic
                              2. Negelected Tropical Disease
                                1. misdiagnosis as psychosis after travel
                                2. Vector
                                  1. Tsetse fly
                                    1. warm+ Shaded
                                      1. 1-6 mo
                                        1. Low infctn rate
                                          1. 2-3 per1000
                                      2. Life cycle
                                        1. 1. Fly bite + injects parasite
                                          1. 2. Metacyclic trypomastigotes → BS trypomastigotes
                                            1. 3. Multiply via binary fission
                                              1. 4. Trypomastigotes in blood
                                                1. 5. Fly bite + ingest parasite
                                                  1. 6. BS parasite→ procylic parasite@ tsetse fly midgut
                                                    1. multiply via binary fission
                                                      1. 7. Procyclic parasite leave midgut→ epimastigotes
                                                        1. 8. multiply @ salivary glands epi→ metacyclic
                                                  2. Human Stages
                                                2. Tsetse fly Stages
                                              2. Signs and Symptoms
                                                1. Signs
                                                  1. Chancre
                                                    1. localised erythema
                                                      1. Indurated
                                                        1. Tender
                                                          1. Lymphadenopathy
                                                            1. trypanosome move to nearby nodes → lymphadenitis
                                                              1. painless
                                                                1. soft
                                                                  1. mobile nodes
                                                                    1. Common in TbG
                                                                      1. @ posterior cervical "Winterbottom's Sign"
                                                                      2. Onset in days
                                                                        1. up to 3 weeks
                                                                        2. Common in TbR
                                                                        3. Hepatosplenomegaly
                                                                          1. Anaemia
                                                                            1. abnormal LFT
                                                                          2. Symptoms
                                                                            1. Parasitaemia
                                                                              1. Myalgia
                                                                                1. Fever
                                                                                  1. Headache
                                                                                    1. Weightloss
                                                                                      1. Rash
                                                                                        1. Itch
                                                                                      2. Complications
                                                                                        1. CVS
                                                                                          1. Myocardits
                                                                                            1. Effusions
                                                                                            2. Endocrince
                                                                                              1. Hypothyroidism
                                                                                                1. Hypoadrenalism
                                                                                                2. CNS
                                                                                                  1. Psychosis
                                                                                                    1. Convulsions
                                                                                                      1. Insomnia/somnalence
                                                                                                        1. Hyper/Para thenesia
                                                                                                          1. Tremors/Ataxia/Focal signs
                                                                                                          2. General
                                                                                                            1. Wasting
                                                                                                              1. Malnutrition
                                                                                                                1. Infections
                                                                                                            2. Dx
                                                                                                              1. Demonstration of Parasite
                                                                                                                1. Aspiration of chancre
                                                                                                                  1. Blood Film
                                                                                                                    1. blood concentration technique
                                                                                                                      1. Quantitative Buffy coat
                                                                                                                        1. QBC
                                                                                                                      2. Bone marrow
                                                                                                                        1. CSF
                                                                                                                          1. Mandatory
                                                                                                                            1. xclude CNS
                                                                                                                              1. Microscopy for trypanosomes
                                                                                                                                1. WCC > 5
                                                                                                                                  1. Morula cells of Mott
                                                                                                                                    1. Big Eosinophillic Plasma cell contain IgM
                                                                                                                                  2. Serology
                                                                                                                                    1. Population screening
                                                                                                                                      1. CATT (Card Agglutination Test)
                                                                                                                                    2. Ddx
                                                                                                                                      1. HIV
                                                                                                                                        1. Toxoplasmosis in HIV
                                                                                                                                          1. CD<400
                                                                                                                                        2. TB
                                                                                                                                          1. Meningitis
                                                                                                                                            1. Lymphoma
                                                                                                                                              1. CNS vasculitis
                                                                                                                                                1. Psychiatric illness
                                                                                                                                                2. Prognosis
                                                                                                                                                  1. Fatal without Tx
                                                                                                                                                3. Staging
                                                                                                                                                  1. Stage 1 (Early)
                                                                                                                                                    1. No CNS involvements
                                                                                                                                                      1. Haemolymphatics
                                                                                                                                                      2. Stage 2 (Late)
                                                                                                                                                        1. CNS involvements
                                                                                                                                                      3. Tx
                                                                                                                                                        1. TbG
                                                                                                                                                          1. S1- Pentamidine
                                                                                                                                                            1. S2 - Eflornithine / ±Nifurtimox
                                                                                                                                                            2. TbR
                                                                                                                                                              1. S1- Suramin
                                                                                                                                                                1. S2- Melarsoprol
                                                                                                                                                                2. Steroids often used
                                                                                                                                                                  1. SE common
                                                                                                                                                                    1. 1-3 weeks
                                                                                                                                                                    2. Control
                                                                                                                                                                      1. Vector control
                                                                                                                                                                        1. Population screening
                                                                                                                                                                          1. Minimise contact
                                                                                                                                                                            1. Prevention
                                                                                                                                                                              1. aerial insecticide
                                                                                                                                                                                1. Tsetse fly trap
                                                                                                                                                                                  1. insectiside impregnated screen
                                                                                                                                                                                    1. wild animal pop reduction
                                                                                                                                                                                      1. removal of woody vegetaion
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