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A diagnosis of human African trypanosomiasis was made on the basis of physical examination findings (figure 1) and the presence of T. brucei rhodesiense noted on a peripheral blood screen obtained at admission (figure 2). Our patient was given 1 dose of intravenous pentamidine and was subsequently given 1 dose of suramin procured from the Centers for Disease Control and Prevention. Because of an elevated WBC count, an elevated total protein level, and an elevated IgM level in CSF samples, CNS involvement was presumed, although the patient had no focal findings or neurologic symptoms. She was treated with intravenous melarsoprol (trivalent organic arsenic) together with prednisone to prevent post-treatment reactive encephalopathy [1, 2]. During week 1 of treatment, the patient received 108 mg of melarsoprol daily for 3 days; during week

2, she received 144 mg of melarsoprol daily for 3 days; and …