Winterbottom's sign

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Winterbottom's sign is seen in the early phase of African trypanosomiasis, a disease caused by the parasites Trypanosoma brucei rhodesiense and Trypanosoma brucei gambiense which is more commonly known as African sleeping sickness. Dr Anthony Martinelli describes Winterbottom's sign as the swelling of lymph nodes (lymphadenopathy) along the back of the neck, in the posterior cervical chain of lymph nodes, as trypanosomes travel in the lymphatic fluid and cause inflammation.

It may be suggestive of cerebral infection.[1]


The term Winterbottom's sign derives from descriptions of the posterior cervical lymphadenopathy associated with African trypanosomiasis made by Dr. Thomas Masterman Winterbottom (1766-1859) in 1803.[2] Contrary to some beliefs, Winterbottom was not a slave trader using the sign to weed out the ill, rather, he was an abolitionist physician who traveled to the newly created colony of Sierra Leone, home to freed American slaves. While working in Sierra Leone, he is credited with extensively documenting the unique tropical diseases of the region and working to improve public health.[3][4]


  1. ^ Ormerod WE (October 1991). "Hypothesis: the significance of Winterbottom's sign". J Trop Med Hyg. 94 (5): 338–40. PMID 1942213. 
  2. ^ Winterbottom TM. An account of the native Africans in the neighbourhood of Sierra Leone. London: C. Whittingham; 1803.
  3. ^
  4. ^ Cox F. History of sleeping sickness (African trypanosomiasis). Infectious Disease Clinics of North America - Volume 18, Issue 2 (June 2004)

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