A 49-year-old woman from Cameroon presented with history of several months of worsening headache, lethargy, left arm weakness, and generalized lymphadenopathy. Brain MRI demonstrated multifocal signal abnormality and enhancement involving the bilateral basal ganglia and cerebral white matter. FDG PET/CT performed as part of lymphadenopathy evaluation demonstrated patchy areas of increased metabolic activity of the brain parenchyma. Human African trypanosomiasis or African sleeping sickness is a protozoan infection caused by Trypanosoma brucei gambiense transmitted by the tsetse fly in sub-Saharan Africa. It is important to recognize the signs and symptoms in nonendemic countries to facilitate early diagnosis and treatment.
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