Clinical Presentation

* Presentation is variable and depends on the infecting subspecies. Infection with T. b. rhodesiense is more acute clinically and progresses more rapidly than T. b. gambiense.
* Symptoms and signs of T. b. rhodesiense infection generally appear within 1–3 weeks of the infective bite. These may include high fever, a chancre at the site of the infective bite, skin rash, headache, myalgia, thrombocytopenia, and less commonly, splenomegaly, renal failure, or cardiac dysfunction. Central nervous system involvement can occur within the first month of infection.
* Symptoms of T. b. gambiense infection are nonspecific, and patients may remain paucisymptomatic for many months after infection. Symptoms and signs may include fever, headache, malaise, myalgia, facial edema, pruritus, lymphadenopathy, and weight loss. Central nervous system involvement occurs after months of infection and is characterized by somnolence, severe headache, and a wide range of neurologic manifestations, including mood disorders, behavior change, focal deficits, and endocrine disorders.
* Untreated HAT infection is eventually fatal.