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Chapter 9 : Trypanosomiasis
Editor:
Lynne S. Garcia1
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Affiliations:
1: LSG & Associates, Santa Monica, California
Content Type: Reference
Publication Year:
2007
Category: Clinical Microbiology
Book DOI:
10.1128/9781555816018
Chapter DOI:
10.1128/9781555816018.ch9
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Trypanosomiasis, Page 1 of 2
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Abstract:
Human infections are caused by Trypanosoma brucei gambiense (West African trypanosomiasis) and Trypanosoma brucei rhodesiense (East African trypanosomiasis). Trypanosomes infecting humans in the Americas belong to the subgenus Tejaraia (Trypanosoma rangeli) and Schizotrypanum (Trypanosoma cruzi). T. rangeli infections are asymptomatic, with no evidence of pathology; however, T. cruzi infections (American trypanosomiasis) can cause considerable morbidity and mortality. A simple and rapid test, the card indirect agglutination trypanosomiasis test, is available, primarily in areas of endemic infection, for the detection of circulating antigens in persons with African trypanosomiasis. Accurate identification of trypanosome species, which is necessary to clarify the epidemiology of human and animal African trypanosomiasis, has been difficult. Great progress has been made over the last 10 years through the application of DNA probe technology, although this has also revealed greater complexity than was previously supposed. The incidence of East African trypanosomiasis is characterized by short epidemics interspersed with long periods of low (often undectable) endemicity. In the chronic stage of Chagas’ disease, trypomastigotes are very rare or absent in the peripheral blood except during febrile exacerbations. Diagnosis depends primarily on culture, xenodiagnosis, or serologic tests. The patient may also be monitored through serologic tests and electrocardiograms. Serologic tests used for the diagnosis of Chagas’ disease include complement fixation, indirect fluorescent-antibody tests, indirect hemagglutination tests, and enzyme-linked immunosorbent assay (ELISA). T. rangeli trypomastigotes can be detected in the peripheral blood by using thin and thick blood smears and concentration techniques.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
Key Concept Ranking
- Restriction Fragment Length Polymorphism
- 0.44177833
- Human African Trypanosomiasis
- 0.42369992
- Trypanosoma brucei rhodesiense
- 0.40153304
0.44177833
Figures
Trypanosomiasis
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig01
Figure 9.1
Distribution of trypanosomes in Africa. (Armed Forces Institute of Pathology photograph.)
10.1128/9781555816018/ch9fig1_thmb.gif
10.1128/9781555816018/ch9fig1.gif
Figure 9.1
Distribution of trypanosomes in Africa. (Armed Forces Institute of Pathology photograph.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig02
Figure 9.2
Life cycle stages of trypanosomes. Amastigotes have been confirmed in the life cycle of Trypanosoma cruzi as one of the stages in the human host, but this stage in humans in African trypanosomiasis is only suspected and not confirmed. (Illustration by Nobuko Kitamura.)
10.1128/9781555816018/ch9fig2_thmb.gif
10.1128/9781555816018/ch9fig2.gif
Figure 9.2
Life cycle stages of trypanosomes. Amastigotes have been confirmed in the life cycle of Trypanosoma cruzi as one of the stages in the human host, but this stage in humans in African trypanosomiasis is only suspected and not confirmed. (Illustration by Nobuko Kitamura.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig03
Figure 9.3
Life cycle of Trypanosoma brucei gambiense and T. brucei rhodesiense.
10.1128/9781555816018/ch9fig3_thmb.gif
10.1128/9781555816018/ch9fig3.gif
Figure 9.3
Life cycle of Trypanosoma brucei gambiense and T. brucei rhodesiense.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig04
Figure 9.4
Trypanosoma brucei gambiense trypomastigotes in peripheral blood smears. Note the small kinetoplast.
10.1128/9781555816018/ch9fig4_thmb.gif
10.1128/9781555816018/ch9fig4.gif
Figure 9.4
Trypanosoma brucei gambiense trypomastigotes in peripheral blood smears. Note the small kinetoplast.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig05
Figure 9.5
Winterbottom’s sign (enlarged cervical lymph nodes in the posterior cervical triangle). (Armed Forces Institute of Pathology photograph.)
10.1128/9781555816018/ch9fig5_thmb.gif
10.1128/9781555816018/ch9fig5.gif
Figure 9.5
Winterbottom’s sign (enlarged cervical lymph nodes in the posterior cervical triangle). (Armed Forces Institute of Pathology photograph.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig06
Figure 9.6
Coronal section of brain showing congested white matter and petechial hemorrhages. (Armed Forces Institute of Pathology photograph.)
10.1128/9781555816018/ch9fig6_thmb.gif
10.1128/9781555816018/ch9fig6.gif
Figure 9.6
Coronal section of brain showing congested white matter and petechial hemorrhages. (Armed Forces Institute of Pathology photograph.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig07
Figure 9.7
Morular cell in the hypothalamus. (Armed Forces Institute of Pathology photograph.)
10.1128/9781555816018/ch9fig7_thmb.gif
10.1128/9781555816018/ch9fig7.gif
Figure 9.7
Morular cell in the hypothalamus. (Armed Forces Institute of Pathology photograph.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig08
Figure 9.8
Close-up view of the meninges showing a morular cell. (Armed Forces Institute of Pathology photograph.)
10.1128/9781555816018/ch9fig8_thmb.gif
10.1128/9781555816018/ch9fig8.gif
Figure 9.8
Close-up view of the meninges showing a morular cell. (Armed Forces Institute of Pathology photograph.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09alg01
Algorithm 9.1
African trypanosomiasis.
10.1128/9781555816018/ch9alg1_thmb.gif
10.1128/9781555816018/ch9alg1.gif
Algorithm 9.1
African trypanosomiasis.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig09
Figure 9.9
Life cycle of Trypanosoma cruzi.
10.1128/9781555816018/ch9fig9_thmb.gif
10.1128/9781555816018/ch9fig9.gif
Figure 9.9
Life cycle of Trypanosoma cruzi.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig10
Figure 9.10
(Top and middle) Trypanosoma cruzi trypomastigotes in a peripheral blood smear. Note the large kinetoplast. (Bottom) Scanning electron micrograph of a trypomastigote of T. cruzi. (Bottom photograph courtesy of David T. John.)
10.1128/9781555816018/ch9fig10_thmb.gif
10.1128/9781555816018/ch9fig10.gif
Figure 9.10
(Top and middle) Trypanosoma cruzi trypomastigotes in a peripheral blood smear. Note the large kinetoplast. (Bottom) Scanning electron micrograph of a trypomastigote of T. cruzi. (Bottom photograph courtesy of David T. John.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig11
Figure 9.11
Trypanosoma cruzi amastigotes in cardiac muscle.
10.1128/9781555816018/ch9fig11_thmb.gif
10.1128/9781555816018/ch9fig11.gif
Figure 9.11
Trypanosoma cruzi amastigotes in cardiac muscle.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig12
Figure 9.12
Epimastigotes of Trypanosoma cruzi.
10.1128/9781555816018/ch9fig12_thmb.gif
10.1128/9781555816018/ch9fig12.gif
Figure 9.12
Epimastigotes of Trypanosoma cruzi.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig13
Figure 9.13
(Upper) Female child with Romaña’s sign. (Armed Forces Institute of Pathology photograph.) (Lower) Male child with Romaña’s sign. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
10.1128/9781555816018/ch9fig13_thmb.gif
10.1128/9781555816018/ch9fig13.gif
Figure 9.13
(Upper) Female child with Romaña’s sign. (Armed Forces Institute of Pathology photograph.) (Lower) Male child with Romaña’s sign. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig14
Figure 9.14
An enlarged heart in a 46-year-old man 13 days after onset of acute Chagas’ disease. (Armed Forces Institute of Pathology photograph.)
10.1128/9781555816018/ch9fig14_thmb.gif
10.1128/9781555816018/ch9fig14.gif
Figure 9.14
An enlarged heart in a 46-year-old man 13 days after onset of acute Chagas’ disease. (Armed Forces Institute of Pathology photograph.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig15
Figure 9.15
Acute chagasic myocarditis. (Original photograph by B. H. Kean; from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
10.1128/9781555816018/ch9fig15_thmb.gif
10.1128/9781555816018/ch9fig15.gif
Figure 9.15
Acute chagasic myocarditis. (Original photograph by B. H. Kean; from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig16
Figure 9.16
Open chagasic heart with thinning of wall. (Original photograph by B. H. Kean; from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
10.1128/9781555816018/ch9fig16_thmb.gif
10.1128/9781555816018/ch9fig16.gif
Figure 9.16
Open chagasic heart with thinning of wall. (Original photograph by B. H. Kean; from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig17
Figure 9.17
(Top) Posterior half of a heart with chronic chagasic cardiopathy. Note the left ventricle dilation and apical aneurysm. (Armed Forces Institute of Pathology photograph.) (Middle) Aneurysmal dilatation and thinning of the apical myocardium, plus marked concentric muscular hypertrophy. (Bottom) Same heart with thin apical myocardium. Note the light shining through the thinned muscle. (Middle and bottom photographs by J. H. Edgecome; from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
10.1128/9781555816018/ch9fig17_thmb.gif
10.1128/9781555816018/ch9fig17.gif
Figure 9.17
(Top) Posterior half of a heart with chronic chagasic cardiopathy. Note the left ventricle dilation and apical aneurysm. (Armed Forces Institute of Pathology photograph.) (Middle) Aneurysmal dilatation and thinning of the apical myocardium, plus marked concentric muscular hypertrophy. (Bottom) Same heart with thin apical myocardium. Note the light shining through the thinned muscle. (Middle and bottom photographs by J. H. Edgecome; from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig18
Figure 9.18
Chagasic megaesophagus. (Original photography by D. N. Reifsnyder; from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
10.1128/9781555816018/ch9fig18_thmb.gif
10.1128/9781555816018/ch9fig18.gif
Figure 9.18
Chagasic megaesophagus. (Original photography by D. N. Reifsnyder; from A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig19
Figure 9.19
Megacolon in an adult male with Chagas’ disease. (Armed Forces Institute of Pathology photograph.)
10.1128/9781555816018/ch9fig19_thmb.gif
10.1128/9781555816018/ch9fig19.gif
Figure 9.19
Megacolon in an adult male with Chagas’ disease. (Armed Forces Institute of Pathology photograph.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09alg02
Algorithm 9.2
American trypanosomiasis.
10.1128/9781555816018/ch9alg2_thmb.gif
10.1128/9781555816018/ch9alg2.gif
Algorithm 9.2
American trypanosomiasis.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig20
Figure 9.20
Life cycle of Trypanosoma rangeli.
10.1128/9781555816018/ch9fig20_thmb.gif
10.1128/9781555816018/ch9fig20.gif
Figure 9.20
Life cycle of Trypanosoma rangeli.
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09fig21
Figure 9.21
Trypanosoma rangeli trypomastigote in a peripheral blood smear. Note the small kinetoplast. (Armed Forces Institute of Pathology photograph.)
10.1128/9781555816018/ch9fig21_thmb.gif
10.1128/9781555816018/ch9fig21.gif
Figure 9.21
Trypanosoma rangeli trypomastigote in a peripheral blood smear. Note the small kinetoplast. (Armed Forces Institute of Pathology photograph.)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
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Tables
Trypanosomiasis
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09tab01
Table 9.1
Classification of trypanosomes infecting humans
Table 9.1
Classification of trypanosomes infecting humans
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09tab02
Table 9.2
Characteristics of East and West African trypanosomiasis
Table 9.2
Characteristics of East and West African trypanosomiasis
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09tab03
Table 9.3
Methods available for the diagnosis of African trypanosomiasis (T. brucei gambiense)
Table 9.3
Methods available for the diagnosis of African trypanosomiasis (T. brucei gambiense)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09tab04
Table 9.4
Methods available for the diagnosis of African trypanosomiasis (T. brucei rhodesiense)
Table 9.4
Methods available for the diagnosis of African trypanosomiasis (T. brucei rhodesiense)
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09tab05
Table 9.5
Characteristics of American trypanosomiais
Table 9.5
Characteristics of American trypanosomiais
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9
/content/10.1128/9781555816018.ch09.ch09tab06
Table 9.6
Trypanosoma cruzi: principal vectors
Table 9.6
Trypanosoma cruzi: principal vectors
Citation:
Garcia L.
2007.
Trypanosomiasis,
p 218-248.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch9