E. Bertrand et al., AFRICAN HUMAN TRYPASONOMIASIS AND MYOCARD ITIS - DIFLUOROMETHYL ORNITHIN TREATMENT, Medecine et maladies infectieuses, 25(3BIS), 1995, pp. 540-542
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.