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A 27-year-old American man who had returned recently from East Africa presented with African sleeping sickness, probably of the Rhodesian (East African) type. High fever, malaise, and watery diarrhea were his predominant symptoms. No trypanosomal chancre was noted. Treatment for malaria in Africa had not been effective. In the emergency department, diagnosis was established by demonstrating trypanosomes on blood smear. Treatment with an IV course of Suramin was successful.