Clinical Background
Chagas Disease is caused by Trypanosoma cruzi, a protozoan that is transmitted by infected Triatominae bugs.
Epidemiology
- Prevalence
- In US, almost exclusively in immigrants from Central and South America
- 16-18 million individuals infected worldwide; roughly 50,000 people die each year from chronic Chagas disease
- Transmission
- Triatomine bugs
- Also occurs via maternal transplacental transfer, blood transfusion, organ transplantation and rarely from ingestion of contaminated water
Organism
- The genus Trypanosoma contains many species of protozoans
- Only 3 cause human disease - T. cruzi, T. brucei gambiense and T. brucei rhodesiense
- Vector-borne from the reduviid bug, Triatoma gerstaeckeri
- Human exposure to feces from infected bugs
Clinical Presentation
- Acute infection
- Mild symptoms occur for 2 weeks to 3 months
- Initial signs include malaise, fever, anorexia, rash and edema
- Most recognized marker is Romaña sign (unilateral painless edema of palpebral and periocular tissues)
- An indurated area of erythema and swelling (chagoma) may indicate the site of entry into the body
- Chronic infection may manifest decades later
- Cardiomyopathy
- Digestive system complications
- Megacolon
- Megaesophagus
