Article: Cerebral trypanosomiasis in an incarcerated man

CLINICAL VISTAS

A 40-year-old First Nations man was transferred to hospital from a Manitoba correctional facility following a 2-week history of headache, nausea, vomiting and drowsiness. He denied any travel outside of Manitoba; family members confirmed this. He admitted to a history of intravenous substance abuse.

On examination the patient was afebrile with no meningism. He had a sudden decrease in level of consciousness associated with a left fixed and dilated pupil and right-sided hemiparesis. Head CT revealed an extensive enhancing space-occupying lesion involving both frontal lobes (Fig. 1). An urgent craniotomy was performed to reduce the tumour and obtain a tissue sample.

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