Human African Trypanosomiasis in a Spanish traveler returning from Tanzania

[...]g-HAT cases in nonendemic countries mainly occur in expatriates or refugees, who are usually diagnosed in the second stage and after a protracted diagnostic process [4]. Since it is rare in nonendemic countries, physicians may not suspect or find it difficult to diagnose this disease, especially if fever and/or unspecific complaints are the only presenting symptoms. An accurate anamnesis, including travel history and incubation and prodromal periods, together with a thorough physical examination, is helpful to guide the diagnostic workup. r-HAT is usually easy to diagnose by blood smear examination, as parasitaemia in these patients tends to be high [8]. Case description On 31 August 2015, a 49-year-old Spanish woman attended the Tropical Medicine Outpatient Clinic (OC) of the Hospital Clínic in Barcelona, Spain, presenting with fever. [...]she visited Lake Enyasi and Manyara National Park before returning to Arusha; from there, she travelled back to Barcelona on 30th August. During her OC visit, she was febrile with axillar temperature of 38°C and had a 1x1 cm erythematous nodule in the left side of her neck, suggestive of arthropod bite. A blood film did not show malaria parasites, and serum was collected for Dengue and Chikungunya serology and polymerase chain reaction, together with blood cultures.