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Wednesday, March 19, 2014

Chagas' Disease





American trypanosomiasis

  • This disease is caused by the parasite Trypanosma cruzi, commonly found in South America. It is transmitted by bites from the reduviid bug, which bites an infected human or animal, then bites a non-infected individual, passing the parasites from the its feces into the wound, causing Chagas' disease.
  • Chagas' disease has two phases: an acute phase that causes an immediate infection, and a late phase that occurs 10 to 30 years later, often resulting in severe heart damage, damage to the esophagus, or damage to the colon.

  • Initial (acute) phase -- lasts 2-4 months
  1. Often no symptoms at all
  2. Boil lesion in skin
  3. Eye swelling if bug bite to eye
  4. Fever
  5. Swollen lymph glands
  6. Headache
  7. Fatigue
  8. Shortness of breath
  9. Confusion
  10. Coma
  • Chronic (late) phase -- occurs 10 to 30 years later
  1. Palpitations
  2. Shortness of breath
  3. Leg swelling (edema)
  4. Difficulty swallowing
  5. Food regurgitation
  6. Severe Constipation

  • Examination -- initial phase:
  1. Romana's sign (swollen, Red Eye)
  2. Chagoma (boil at site of bite)
  3. Enlarged lymph glands
  4. Enlarged liver
  5. Enlarged spleen
  6. Shortness of breath
  7. Leg swelling (edema)
  8. Stiff/rigid neck
  • Laboratory findings -- initial phase:
  1. Blood examined under microscope with special techniques
  2. Serologic IgM and IgG blood tests
  • Examination -- chronic (late) phase
  1. Lung crackles
  2. Leg swelling
  3. Irregular heart beat
  4. Distended abdomen
  • Laboratory findings -- chronic phase
  1. Culture
  2. Xenodiagnosis (special technique)
  3. Serologic IgG blood tests

  • Often does not work.
  • Medications that may be tried: Nifurtimox or Benznidazole
  • Diuretics, if heart failure occurs, and Amiodarone for heart arrhythmias

  • The initial (acute) disease is usually seen in children and causes death in 10% of the reported cases. In severe forms, the acute disease can cause Meningitis or heart failure.
  • The late (chronic) form causes heart arrhythmias, heart failure, and enlarged esophagus and colon. It is a very severe disease. Heart arrhythmias can cause sudden death.

  • Toxoplasmosis

1 comments:

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