Méningoencéphalite parasitaire : à propos d'un cas de trypanosomiase humaine africaine

Human African trypanosomiasis is an exclusively African parasitic disease transmitted by the arthropod glossina, commonly known as the tsetse fly. It progresses in two stages, a first period of hematic lymphatic dissemination, followed by damage to the central nervous system which results in “sleeping sickness”. It is usually lethal if left untreated. Diagnosis requires visualization of the parasite in the blood smear or in the cerebrospinal fluid. Several differential diagnoses can be discussed. We report the case of a 55-year-old Malian man who presented slow psychomotor activity and a confused state that had developing slowly and insidiously over a few months. Magnetic resonance imaging revealed bilateral and symmetrical mesencephalic and diencephalic damage. Lumbar puncture revealed lymphocytic meningitis. Many serologies were falsely positive. The patient was treated with a double therapy eflornithine nifurtimox (NECT protocol), which allowed the patient to regain his independence.