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Am J Trop Med Hyg. 2019 May 6. doi: 10.4269/ajtmh.18-0889. [Epub ahead of print]

Case Report: Trypanosoma brucei Gambiense Human African Trypanosomiasis as the Cause of Fever in an Inpatient with Multiple Myeloma and HIV-1 Coinfection.

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J.D. MacLean Centre for Tropical Diseases, Montreal, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Division of Infectious Diseases, Department of Medical Microbiology, McGill University Health Centre, Montreal, Canada.
National Reference Centre for Parasitology, Montreal, Canada.


We report the case of a 64-year-old woman found to have urban-acquired Trypanosoma brucei (T.b.) gambiense human African trypanosomiasis (HAT) as the cause of sustained fever starting 9 months after returning to Canada from Democratic Republic of the Congo, in the context of concomitant multiple myeloma and HIV-1 coinfection. Approaches for the management of both clinical stages of T.b. gambiense HAT are well defined for endemic settings using current diagnostics and treatments. However, few data inform the diagnosis and management of patients with bone marrow suppression from active malignancy, recent anticancer therapy, or HIV coinfection. We discuss the implications of immunosuppression for diagnosis and management of T.b. gambiense HAT.


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