Otte J A, Nouwen J L, Wismans P J, Beukers R, Vroon H J, Stuiver P C
Havenziekenhuis, afd. Tropische Geneeskunde en Neurologie, Rotterdam.
Ned Tijdschr Geneeskd. 1995 Oct 14;139(41):2100-4.
Of the four most dangerous protozoal infections acquired in (sub)tropical regions, falciparum malaria, amoebic abscess of the liver, visceral leishmaniasis (kala azar) and African trypanosomiasis (sleeping sickness) only the fourth was up to now unreported in the Dutch medical literature. Two case histories are presented: a Cameroonian woman, resident in the Netherlands for two years, suffering from West African type sleeping sickness, and a Dutch tourist who acquired East African trypanosomiasis while travelling through Zimbabwe. Although the parasites are morphologically identical, clinical and epidemiological characteristics are distinctly different. The West African type, rarely if ever observed in Europeans, has an insidious chronic course leading to the features of classical sleeping sickness. Differential diagnosis is difficult. The East African variety runs an acute course in Europeans leading to death within days due to myocarditis. It is therefore mandatory for the diagnosis to be made as soon as possible in order to initiate specific therapy. Both patients recovered after specific therapy.
在（亚）热带地区感染的四种最危险的原生动物感染中，恶性疟疾、阿米巴肝脓肿、内脏利什曼病（黑热病）和非洲锥虫病（昏睡病），到目前为止只有第四种在荷兰医学文献中未被报道。本文介绍了两个病例：一名在荷兰居住两年的喀麦隆妇女，患有西非型昏睡病；一名荷兰游客在津巴布韦旅行期间感染了东非锥虫病。虽然这些寄生虫在形态上相同，但临床和流行病学特征明显不同。西非型在欧洲人身上很少见，病程隐匿且呈慢性，会导致典型昏睡病的症状。鉴别诊断困难。东非型在欧洲人身上呈急性病程，由于心肌炎会在数天内导致死亡。因此，必须尽快做出诊断以便开始特异性治疗。两名患者在接受特异性治疗后均康复。
