Clinical features
- subcutaneous chancre develops at site of the bite of an infected tsetse fly
- irregular fevers and weakness
- lymphadenopathy:
- especially posterior cervical nodes in T. gambiense infection - Winterbottom's sign
- especially posterior cervical nodes in T. gambiense infection - Winterbottom's sign
- other features
- headache
- arthralgia
- weight loss
- peripheral and pulmonary oedema
- pericardial effusions
- ascites
- nephritis
- amenorrhoea/impotence
- late features:
- CNS disturbance:
- ataxia
- dyskinesias
- dementia
- hypersomonelence
- coma
- psychiatric disturbance:
- apathy
- depression
- reversal of the sleep-wake cycle
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