We report a case of human African trypanosomiasis caused by Trypanosom
a brucei rhodesiense. After the febrile period of parasite disseminati
on, the patient had meningeal involvement but normal CT, MRI showed th
e appearances of meningitis. After two periods of arsenical treatment,
a severe encephalopathy occurred suggesting post-therapeutic reactive
encephalitis (PTRE). Nevertheless, T2-weighted MRI showed no oedema,
but focal bilateral high signal areas in the white matter, PTRE was ex
cluded and a third course of treatment was undertaken. The lesions pro
gressively disappeared.