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Trypanosoma brucei

Summary of Trypanosoma brucei
Trypanosoma brucei is a species of parasitic protozoan that causes African trypanosomiasis, also known also as African sleeping sickness. Its two recognized subspecies are Trypanosoma brucei rhodesiense (southern and eastern Africa) and Trypanosoma brucei gambiense (central and western Africa). The painful bite of the tsetse fly transmits the parasite, and the clinical syndrome is characterized by recurring fever (because of antigenic variation), enlarged lymph nodes, encephalitis (manifested in confusion and sleep cycle disruptions), and eventual coma. Treatment is with melarsoprol for central nervous system involvement and suramin for blood-borne infection.

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Trypanosoma brucei

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Trypanosoma brucei

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African sleeping sickness (Trypanosoma brucei) is transmitted via the painful bite of the .

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A 31-year-old man is brought to the emergency department by his wife following a 2-month history of intermittent fevers, headaches, and joint pain. His wife also complains that he has been confused and lethargic lately, often falling asleep in the middle of the day. On examination, there is marked hepatomegaly and lymphadenopathy which is particularly noticeable in the back of the neck. There is also a well-circumscribed, erythematous lesion on his right arm. His temperature is 38.7°C (101.6°F), pulse is 80/min, respirations are 18/min, and blood pressure is 110/70mmHg. His past medical history is unremarkable and he has recently returned from a trip to Kenya. A peripheral blood smear is ordered along with other investigations and is shown below. Which of the following is the most appropriate pharmacotherapy for this patient?

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