After treatment for Gambian African Trypanosomiasis, the patient should be followed by repeated CSF examinations in order to detect disease relapse. Most patients manifest relapse by a rising WBC counts in the CSF, associated with recurrent symptoms.
Clinical Status
Lumbar Puncture to Monitor CSF
asymptomatic
every 6 months for 2 years
symptomatic
less than 6 months
borderline elevations in CSF WBC counts and asymptomatic (20-50 per µL after melarsoprol or eflornithine; 6-19 per µL after pentamidine)
less than 6 months
Definite criteria for relapse:
(1) demonstration of trypanosomes in CSF, blood or lymph nodes
Presumptive diagnosis for relapse after melarsoprol or eflornithine:
(1) CSF WBC count > 50 per µL, AND if greater than previous count
(2) CSF WBC count 20-50 per µL AND higher than last count AND presence of symptom recurrence
Presumptive diagnosis for relapse after pentamidine:
(1) CSF WBC > 20 per µL
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