Cough may also occur. Liver enzymes and erythrocyte sedimentation rates are usually elevated, and anemia is common. Chronic disease results in a variety liver and gallbladder abnormalities. Heavy infections result in mild anemia and eosinophilia, but infections are usually asymptomatic. Heavy infections may result in abdominal cramping, nausea, vomiting, flatulence, diarrhea, tenesmus, and weight loss.
Mild infections are usually asymptomatic.
Ivermectin is sometimes also used in combination with albendazole. Note that the disorder may occur years after leaving the tropics. Trypanosomiasis is caused by protozoal parasites, Trypanosoma brucei rhodesiene or T b gambiense , transmitted by bite of the tsetse fly. The hemolymphatic stage is characterized by high fevers lasting several days, with symptom-free periods of days to weeks. Less common manifestations of this stage are severe headache, malaise, arthralgia, lymphadenopathy, circinate rash, pruritis, and hepatosplenomegaly.