Rickettsia africae Infection in Man after Travel to Ethiopia

often given with prednisolone, would have been necessary. In pregnant women with West African (T. brucei gambiense) stage II disease, either melarsoprol or eflornithine can be used, but neither is effective for East African disease. Although efl ornithine can abort early pregnancies and cause disordered organogenesis (9), the severe encephalopathy associated with melarsoprol makes efl ornithine a preferable option for single-agent treatment. However, nifurtimox–efl ornithine combination therapy will soon replace single-drug regimens for stage II T. brucei gambiense cases (10). We believed evidence was insuffi cient to withhold suramin therapy for this highly fatal disease. Because of the uncertainty about effects of pregnancy on the ability to clear trypanosomes, the patient will be followed up for signs of relapse. The danger of HAT should be specifi cally highlighted for all travelers to trypanasomiasisendemic regions, particularly pregnant travelers because of potential harm to unborn children.