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By: abdinassir mohomed hersi
“nasri”
Trypanosomiasis
25/may/2016

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Contents
GENERAL OVERWIEW1
PATHOLOGICAL OVERVIEW2
CLINICAL DIAG. OVERVIEW3
THERAPEUTICAL OVERVIEW4

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GENERAL
OVERWIEW
1

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General overview
 Trypanosomiasis refers to african
sleeping sicknesss and american
sleeping sickness, two chronic and
eventually fatal diseases caused by
species of trypanosoma.
[ referenes and books]
● Richard A harvey pharmacology
● lange meical microbiology

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General overview
T. Brucei
-Causes sleeping
sickness in africa
-Transmitted by tsetse fly
- of two types :-
1.T.B. gambiense
slow to enter CNS and
treated with (suramin ,
pentamidine) in early
stages.
In west africa.
2. T.B. rhodesiense
Not fatal, early invade
CNS and treated with
(melarsopral)
in east africa.
types
T. Cruzi
-causes cardiomyopathy
in american infants
(chagas disease)
-transmitted by triatomid
bug in feaces
-treated by (nifurtimox)

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PATHOLOGICAL
OVERVIEW2

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Pathological Overview
Transform
to
multicyclic
and wait
next bite
Metacyclic
Trypo-
mastigote
Transform
to blood
trypo-
mastigote
and
multiply
MIDGUT:
Transformed
to procyclic
trypo-
mastigote
and multiply
SALIVA:
Transform
to epi-
mastigote
and
multiply
Life Cycle
Tsetse bite normal
subjec with
Diagnostic stage
Infective stage
African tryp

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Pathological Overview
wait next
bite
Metacyclic
Trypo-
mastigote
Transform to
Amastigote
intracellularly
In RES
Transform
to trypo-
mastigote
and
released to
blood
Either
recycle
again or
form
psuedocyst
Life Cycle
Reduviid bug bite
normal subjec with
Diagnostic stage
Infective stage
American tryp

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pathology
 African trypanosoma exhibit
remarkable antigenic variation on
their surface glycoprotein with
hundreds of antigens for:
- drugs in treatment
- immunity
While american one exhibit
lanosterol C14alpha demethylase
which is indispensible.
[ referenes and books]
● Richard A harvey pharmacology
● lange meical microbiology

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CLINICAL DIAG.
OVERVIEW3

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Signs and symptoms
-Demylinating
encephalitis:
fever, headache
myalgia and
samnolence.
- lymph-
adeno-pahty
( winterbottom’s
sign)
-others
-trypanosomal
chancre is
seen.
It is painfull.
-it disappear
after 10 days
-meningo
encephalitis.
-excessive
sleeping.
-Weight loss.
-Coma
-death
On bite
site
Early late
African tryp

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Question?
What causes the sleeping?!!!!
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Signs and symptoms
-Mild fever
-Hepatomegaly
-Splenomegaly
-Asymptomatic
-Resolve in two
months or can
be treated
-chagoma is
seen.
If it is the eye,
it cause
unilateral
palpebral
swelling called
Roman’s sign
-Myocarditis
-Arrhythmia
-Mega colon
-Achlasia
-Death is due
to heart
failure
On bite
site
Early late
American tryp

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Remember that word
C C C C
Cruzi Chagas Cardio-
myo-
pathy
mega
Colon

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Diagnosis
Diagnosis for T.BruceiDiagnosis for T.BruceiDiagnosis for T.BruceiDiagnosis for T.Brucei
Specimen: blood, lymph
Csf and chancre
BoneBone
marrowmarrow
aspirateaspirate
ELISAELISA
IFA andIFA and
CATTCATT
ThickThick
and thinand thin
filmfilm

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Diagnosis
Diagnosis for T.cruziDiagnosis for T.cruziDiagnosis for T.cruziDiagnosis for T.cruzi
Specimen: blood (NNN)
BoneBone
marrowmarrow
aspirateaspirate
ELISAELISA
XenoXeno
diagnosisdiagnosis
but fatalbut fatal
MuscleMuscle
biobsybiobsy

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THERAPEUTICAL
OVERVIEW4

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nifurtimox
Benznidazole
suramin
melarsoprol
pentamidine
treatment

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treatment
Uptake: endocytosis by the protzoa
Mechanism: inhibit parasite
Enzymes those are important for
Energy production
Side effects: renal toxicity and
others
suraminsuramin

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treatment
Uptake: by energy dependent carrier
(resistance associated)
Mechanism: interact with DNA
Side effects: tachycardia , dyspnoea
Vomiting and others.
PentamidinePentamidine
isethionateisethionate

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treatment
Mechanism: react with sulfhydryl
Group in parasite and host.
Pharmacokinetics: absorbed from
GIT, and appear in CSF.
Side effects: tachycardia , dyspnoea
Vomiting and others.
melarsoprolmelarsoprol

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treatment
 for african tryp, primary TTT is
suramin sodium but pentamidine
used as alternative drug.
 If CNS symptoms appear suramin
sodium followed by melarsoprol.
 for american tryp, early form
canbe treated by nifurtimox (some
times used with gamma interferon)
and benznidazole is alternative.
Chronic form is untreatable!!!!

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Prepared with :
A.Rahmaan Alnagr
Osman Abdalla
Tahra Gad
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“Take it easy , every thing can be done”
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