Complications include meningitis and other neurological disorders, myocarditis, pneumonia, and nephritis. 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. Weight loss and debilitation also occur, and myocarditis may develop.
Treatment is complex and toxic, and depends on the infecting organism and stage of illness.
Among the medications currently in use are suramin, melarsoprol, pentamidine, eflornithine, and corticosteroids. Epidemic louse-borne typhus is currently most prevalent in mountainous areas of Africa, Asia, and Latin America. Other common manifestations are delirium, conjunctival injection, photophobia, eye pain, flushed facies, hearing loss, hypotension, pulmonary involvement, renal insufficiency, and splenomegaly. Recovery may be spontaneous, or complications, including pneumonia, circulatory collapse, myocarditis, and uremia may lead to death. Treatment is with doxycycline 200 mg in a single dose or until the patient is afebrile for 24 hours.