An African visitor in Brazil

A Canadian man came to the hospital with history of daily fever in the afternoon, for five days, ranging from 38.5oC to 39oC, headache, muscle pain and asthenia. He is a photographer enthusiastic about wild life and had been to Zimbabwe for 14 days, where he filmed groups of lions and animals of the African megafauna. Upon examination, he presented a hyperemic skin lesion in the posterior region of the thorax, which appeared after an insect bite when he was concluding his visit to Africa, however the lesion persisted until admission to the hospital (Figure 1). A complete blood count and thick blood smear revealed the presence of trypanosomes (Figure 2), probably from the species Trypanosoma brucei rhodesiense. The African trypanosomes (Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense) are morphologically indistinguishable. The acute disease with the clinical characteristics described above, and the location where the patient was contaminated point Figure 1. Thick blood smear with trypanosoma Figure 2. Skin lesion