Abstract
The two classical forms of human trypanosomoses are sleeping sickness due to Trypanosoma brucei gambiense or T. brucei rhodesiense, and Chagas disease due to T. cruzi. However, a number of atypical human infections caused by other T. species (or sub-species) have been reported, namely due to T. brucei brucei, T. vivax, T. congolense, T. evansi, T. lewisi, and T. lewisi-like. These cases are reviewed here. Some infections were transient in nature, while others required treatments that were successful in most cases, although two cases were fatal. A recent case of infection due to T. evansi was related to a lack of apolipoprotein L-I, but T. lewisi infections were not related to immunosuppression or specific human genetic profiles. Out of 19 patients, eight were confirmed between 1974 and 2010, thanks to improved molecular techniques. However, the number of cases of atypical human trypanosomoses might be underestimated. Thus, improvement, evaluation of new diagnostic tests, and field investigations are required for detection and confirmation of these atypical cases.
Highlights
Trypanosomes are protozoan parasites found worldwide, infecting humans, domestic and wild animals, most often transmitted by blood-sucking insects
human African trypanosomosis (HAT) is a fatal disease occurring in sub-Saharan Africa and transmitted by tsetse flies, caused by two subspecies of trypanosomes: T. brucei gambiense or T. b. rhodesiense [1], which is derived from the animal parasite T. b. brucei that has acquired the ability to infect humans [1]
19 cases of atypical human trypanosomoses (a-HT) caused by T. b. brucei [1,6,7,8], T. vivax [1], T. congolense [9], T. evansi [10,11,12,13] and T. lewisi [14,15,16,17,18,19,20,21], which were all considered non-infective to humans, have been reported
Summary
Trypanosomes are protozoan parasites found worldwide, infecting humans, domestic and wild animals, most often transmitted by blood-sucking insects. The disease is endemic in Latin America and in most cases is chronic and asymptomatic [2] In addition to these species, T. rangeli is a human infective species, considered nonpathogenic [1]. Brucei [1,6,7,8], T. vivax [1], T. congolense [9], T. evansi [10,11,12,13] and T. lewisi [14,15,16,17,18,19,20,21], which were all considered non-infective to humans, have been reported. It was decided to review these cases of a-HT, leading to an international collaboration to further evaluate their actual occurrence
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