AFRICAN HUMAN TRYPASONOMIASIS AND MYOCARDITIS - DIFLUOROMETHYL ORNITHIN TREATMENT

The authors report a case of human african trypanosomiasis in a patient having left Zaire 3 years before. The first signs were those of myocarditis. Signs of hypertrophic myocarditis were noticed with echocardiography, thallium scintigraphy and nuclear magnetic resonance. Trypasonomiasis was shown by spinal fluid tests (520 cell/ml with lymphocytes : 95 %; proteinorachia : 1,3 g/l; indirect immunofluorescence : 1/16) and blood tests (indirect immunofluorescence 1/1600, hemagglutination 1/1024). The patient was treated with intraveinous difluoromethylornithin (400 mg/a day during 14 days). The course has been favourable. After 2 years follow-up, signs of trypanosomiasis disappeared. Concerning cardiac signs, myocardial hypertrophy was reduced but Ist degree atrioventricular block is still observed. The authors point up that it is necessary to seek cardiac signs which are frequent in human african trypanosomiasis. An early treatment is useful for a better outcome of nervous and cardiac signs. If there is an atrioventricular block, treatment with difluoromethylornithin has to be cautious and controlled.