Chagas disease

Chagas disease

Chris Schach

Author Bio -

Key Points
*Infectious disease spread by an insect, the reduvid bug
*Caused by the trypanosome cruzi parasite
*Cutaneous symptoms present as swelling of one eye, red and swollen tissue at the area of the bite

Chagas disease is a infectious disease, fairly common in Central and South America. It is caused by the trypanosome cruzi parasite, which is closely related to the parasite which causes African Sleeping sickness, and is spread by the bite of the reduvid bug. It presents in two stages with varying symptoms. In the acute phase, when and if symptoms present, they include fever and malaise. Acute cutaneous symptoms may include the swelling of one eye, and red, swollen tissue at  the site of the bite. The chronic phase of the disease occurs once the disease goes into remission after the acute phase. Symptoms may not appear for many years, but when they do they can include constipation, digestive problems, abdominal pain, and difficulty swallowing, chest pain or heart palpitations. If untreated, the condition can lead to severe heart and digestive problems, even leading to heart failure.

Chagas disease is a major health problem in South and Central America, and also appears in the United States, primarily in connection with immigrants.  Usually transmitted by the reduvid bug bite itself, Chagas’ can also spreads through blood transfusions from carriers. It can also be passed to infants during birth.

Differential Diagnosis (Other conditions with similar appearance)

Malaria
Mononucleosis
Typhoid fever
Leishmaniasis
Schistosomiasis
Toxoplasmosis
Colonic obstruction (chronic form)

Diagnosis
Key Points
*Diagnosis based on physical examination and  symptoms
*Blood and other tests will be performed to confirm diagnosis and determine the phase and extent of the condition

Initial diagnosis of Chagas disease is based on the specific combination of physical and internal symptoms. Other tests, including blood cultures, enzyme-linked immunoassay, electro- and echocardiograms, and chest x-rays can confirm the diagnosis and determine the phase and extent of the condition.

Treatment
*All cases should be treated
*Goal of treatment is to eliminate the parasite and control of physical symptoms
*If left untreated , can result in death

Chagas disease should not go untreated in any phase, as it can lead to serious complications in approximately 30% of affected persons, even death, if left untreated. The goal of treatment in either phase is to eliminate the parasite, with the secondary goal being the control of the more serious physical symptoms. The two drugs most often used to treat Chagas disease are Benznidazole and Nifurtimox. These medications do have side effects, which may be more severe in older persons.

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