{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:41:02Z","timestamp":1784126462505,"version":"3.55.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Human African trypanosomiasis incidence has declined, but diagnosis remains difficult, especially in nonendemic areas. Our patient presented with fever, progressive lethargy, and weight loss for 5 months and had previously traveled to Ghana and Cameroon but had not been to areas with recently reported African trypanosomiasis. Extensive workup was negative, except for lymphocytic pleocytosis in cerebrospinal fluid; ultimately, a bone marrow aspiration revealed necrotizing granulomatous inflammation with 2 trypanosomes discovered on the aspirate smear, consistent with Trypanosoma brucei. The patient was treated with combination nifurtimox and eflornithine with full recovery.<\/jats:p>","DOI":"10.1093\/ofid\/ofab377","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T18:09:57Z","timestamp":1626372597000},"source":"Crossref","is-referenced-by-count":4,"title":["A Wandering Missionary\u2019s Burden: Persistent Fever and Progressive Somnolence in a Returning Traveler"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6494-2142","authenticated-orcid":false,"given":"Kruti J","family":"Yagnik","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, Texas, USA"},{"name":"Parkland Health and Hospital System, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alonso","family":"Pezo-Salazar","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, Texas, USA"},{"name":"Parkland Health and Hospital System, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Division of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse Manuel","family":"Jaso","sequence":"additional","affiliation":[{"name":"Division of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominick","family":"Cavuoti","sequence":"additional","affiliation":[{"name":"Division of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Nelson","sequence":"additional","affiliation":[{"name":"Parkland Health and Hospital System, Dallas, Texas, USA"},{"name":"Division of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J","family":"Chancey","sequence":"additional","affiliation":[{"name":"Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan L","family":"McKenna","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laila M","family":"Castellino","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, UT Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"2021080916405486200_CIT0001","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1016\/S0140-6736(17)31510-6","article-title":"Human African trypanosomiasis","volume":"390","author":"B\u00fcscher","year":"2017","journal-title":"Lancet"},{"key":"2021080916405486200_CIT0002","doi-asserted-by":"crossref","first-page":"e0008261","DOI":"10.1371\/journal.pntd.0008261","article-title":"Monitoring the elimination of human African trypanosomiasis at continental and country level: Update to 2018","volume":"14(5)","author":"Franco","year":"2020","journal-title":"PLoS Negl Trop Dis."},{"key":"2021080916405486200_CIT0003"},{"key":"2021080916405486200_CIT0004","doi-asserted-by":"crossref","first-page":"456","DOI":"10.7326\/0003-4819-158-6-201303190-00005","article-title":"GeoSentinel surveillance of illness in returned travelers, 2007\u20132011","volume":"158","author":"Leder","year":"2013","journal-title":"Ann Intern Med"},{"key":"2021080916405486200_CIT0005","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1111\/j.1708-8305.2011.00576.x","article-title":"Human African trypanosomiasis in non-endemic countries (2000\u20132010) [published correction appears in J Travel Med 2012; 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