Trypanosomiasis in an infant from India.

Human trypanosomiasis is endemic in Africa and South America. Human African Trypanosomiasis (HAT) also known as sleeping sickness is caused by Trypanosoma brucei rhodesiense (in East and South Africa) or Trypanosoma brucei gambiense (in West and Central Africa)1. Disease due to T.b. rhodesiense progresses rapidly over weeks while disease due to T.b. gambiense tends to be chronic. In both the cases, infection leads to CNS involvement and if untreated even death. American trypanosomiasis known as Chagas disease is caused by T. cruzi2. HAT is transmitted by tsetse fly while the American variety is transmitted by reduviid bugs. Human trypanosome infections like the ones seen in Africa and South America are unknown in India3. There have been only three documented cases of Trypanosomiasis reported from India. Two cases of self-limiting febrile illness due to Trypanosoma lewisi were reported in 19744 of an adult couple who lived in a rat-infested village and symptoms resolved without specific treatment after two to three days. Repeat blood films taken eight weeks later were found negative. Another unusual case of Trypanosoma evansi was reported from rural parts of Chandrapur district in Maharashtra in an adult male farmhand with recurrent febrile episodes and he responded to suramin2. Human infection by animal species of Trypanosoma is not seen due to presence of trypanolytic factor in human serum2. A one and a half month old girl staying in a rat infested house in Mumbai presented with fever, hepatosplenomegaly, thrombocytopenia and blood films teeming with multiple trypanosomes morphologically similar to Trypanosoma lewisi.