AFRICAN HUMAN TRYPASONOMIASIS AND MYOCARD ITIS - DIFLUOROMETHYL ORNITHIN TREATMENT

The authors report a case of human african trypanosomiasis in a patien t having left Zaire 3 years before. The first signs were those of myoc arditis. Signs of hypertrophic myocarditis were noticed with echocardi ography, thallium scintigraphy and nuclear magnetic resonance. Trypaso nomiasis was shown by spinal fluid tests (520 cell/ml with lymphocytes : 95 %; proteinorachia : 1,3 g/l; indirect immunofluorescence : 1/16) and blood tests (indirect immunofluorescence 1/1600, hemagglutination 1/1024). The patient was treated with intraveinous difluoromethylorni thin (400 mg/a day during 14 days). The course has been favourable. Af ter 2 years follow-up, signs of trypanosomiasis disappeared. Concernin g cardiac signs, myocardial hypertrophy was reduced but Ist degree atr ioventricular block is still observed. The authors point up that it is necessary to seek cardiac signs which are frequent in human african t rypanosomiasis. An early treatment is useful for a better outcome of n ervous and cardiac signs. If there is an atrioventricular block, treat ment with difluoromethylornithin has to be cautious and controlled.