Winterbottom's sign refers to lymphadenopathy at the base of the neck and is most closely associated with which disease?

• A. African sleeping sickness
• B. Malaria
• C. Leishmaniasis
• D. Filariasis

Answer: (A)

Winterbottom's sign is the appearance of enlarged lymph nodes at the base of the neck, a clue that points to African sleeping sickness. This disease, caused by Trypanosoma parasites transmitted by tsetse flies in sub-Saharan Africa, often shows prominent posterior cervical lymphadenopathy as the parasites spread through the lymphatic system. The sign is a classic finding associated with African trypanosomiasis and helps differentiate it from other tropical illnesses. Malaria, while presenting with fever and systemic symptoms, does not characteristically produce this neck lymph node pattern. Leishmaniasis and filariasis can involve lymph nodes or cause swelling, but the specific posterior cervical lymphadenopathy described here is most strongly linked to African sleeping sickness.