Chagas disease: Difference between revisions
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**Localized swelling at the area of parasite entry | **Localized swelling at the area of parasite entry | ||
*Non-specific signs and symptoms | *Non-specific signs and symptoms | ||
**[[Fever]], fatigue, | **[[Fever]], [[fatigue]], [[myalgia]], [[headache]], anorexia, [[vomiting]], [[diarrhea]] | ||
*Serious complications | *Serious complications | ||
**[[Myocarditis]], [[arrhythmia]], [[encephalitis]] | **[[Myocarditis]], [[arrhythmia]], [[encephalitis]] | ||
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*Between 20-40% of patients will develop chronic complications | *Between 20-40% of patients will develop chronic complications | ||
*'''Cardiac complications''' | *'''Cardiac complications''' | ||
**Dilated cardiomyopathy (CHF) | **Dilated cardiomyopathy ([[CHF]]) | ||
**Dysrhythmias | **[[Dysrhythmias]] | ||
*'''GI complications''' | *'''GI complications''' | ||
**Megaesophagus | **Megaesophagus | ||
**Megacolon | **Megacolon | ||
**Achalasia | **[[Achalasia]] | ||
**Hepatosplenomegaly (secondary to HF) | **[[Volvulus]] | ||
**[[Hepatomegaly|Hepatosplenomegaly]] (secondary to HF) | |||
*'''Neuro symptoms''' | *'''Neuro symptoms''' | ||
**Neuritis | **Neuritis | ||
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==Evaluation== | ==Evaluation== | ||
*[[ECG]] | *[[ECG]] | ||
* | *[[LFTs]] | ||
*Blood smear | *Blood smear | ||
**Can visualize parasites | **Can visualize parasites | ||
**PCR, ELISA, | **PCR, ELISA, immunofluorescence | ||
==Management== | ==Management== | ||
*Benznidazole or Nifurtimox | *[[Benznidazole]] or [[Nifurtimox]] | ||
*Symptomatic treatment | *Symptomatic treatment | ||
Revision as of 16:35, 10 September 2019
Background
- Also known as American Trypanosomiasis
- Endemic in rural parts of Cental and South America
- Rare cases found in Southern United States
- Caused by the parasite trypanosoma cruzi
- Vector: Reduviid (kissing bug)
- The parasite is transmitted in the feces of the host vector
- When the vector bites, it also defecates and the parasites enter the blood stream through the bite wound
Transmission
- Disease of poverty
- Spread by the Triatominae bug (also known as the kissing bug)
- The Triatomina bug thrives in housing that is old, has thatched roofs and dwellings where the roof does not abut the wall.
- Spread by the Triatominae bug (also known as the kissing bug)
- Other methods of transmission
- Vertical (mother to child)
- Transfusion/organ donation
Clinical Features
Acute phase
- Romañas sign
- swelling of the eye thought to be secondary to rubbing the feces into the eye
- Chagoma
- Localized swelling at the area of parasite entry
- Non-specific signs and symptoms
- Serious complications
Chronic phase
- Between 20-40% of patients will develop chronic complications
- Cardiac complications
- Dilated cardiomyopathy (CHF)
- Dysrhythmias
- GI complications
- Megaesophagus
- Megacolon
- Achalasia
- Volvulus
- Hepatosplenomegaly (secondary to HF)
- Neuro symptoms
- Neuritis
Differential Diagnosis
Evaluation
Management
- Benznidazole or Nifurtimox
- Symptomatic treatment