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East African trypanosomiasis stage 1 — DTM&H MCQ

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ModerateProtozoal InfectionsEast African trypanosomiasis stage 1DTM&H

A 34-year-old game ranger in Tanzania develops acute high fever, headache, and myalgia 5 days after a tsetse fly bite. A chancre is present and blood film shows motile trypanosomes. CSF is normal. What is the most appropriate treatment?

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Correct answer: A — Suramin intravenously

Stage 1 T. b. rhodesiense in East Africa requires suramin. Eflornithine and NECT are effective against gambiense but not rhodesiense. Fexinidazole is approved for gambiense only. Benznidazole treats Chagas disease. Rhodesiense progresses much more rapidly than gambiense, making prompt species distinction essential.

Reference: WHO Guidelines on HAT; Manson's Tropical Diseases