Complications
Anti-trypanosomal drugs have the potential for significant toxicities. Fexinidazole has been associated with neuropsychiatric adverse effects, QT prolongation, neutropenia, and gastrointestinal adverse effects. Pentamidine has been associated with injection site pain, hypotension, cardiac disorders, nephrotoxicity, leukopenia, thrombocytopenia, anaemia, acute pancreatitis, hypoglycaemia, hyperglycaemia, and diabetes. Eflornithine may cause bone marrow suppression, gastrointestinal adverse effects, vertigo, tremor, and, more rarely, seizures, and psychotic reactions or hallucinations. Suramin is associated with hypersensitivity reactions, gastrointestinal adverse effects, drug rash, peripheral neuropathy, agranulocytosis, haemolytic anaemia, thrombocytopenia, and nephrotoxicity. Melarsoprol is a highly toxic drug, and can cause encephalopathy, skin reactions, exfoliative dermatitis, gastrointestinal adverse effects, myocardial damage, hypertension, cardiac failure, and albuminuria.[32]
Patients who survive second-stage disease have reported lasting neurological complications including sleep difficulties, speech problems, headaches, muscle weakness, and personality changes.[159]
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