Chagas disease

Vector: Triatoma, Rhodnius, Panstrongylus – infected bug transmits via feces into bite wound

Agent: Trypanosoma cruzi

Clinically

• Acute phase

• Romana’s sign or a chagoma
• may be parasitaemia, fever, lymphadenopathy, or can be entirely asymptomatic.

• Chronic Phase
• Indeterminate form: asymptomatic, may last for life
• Cardiac form: ECG abnormalities, myocardiopathy, megacardia, apical aneurysm
• Digestive form: megaoesophagus, megacolon

• Opportunistic disease may re-emerge when immune-compromised

Parasitological diagnosis: blood films, xenodiagnosis (feed on pt then dissect triatomine gut),  PCR

Treatment

• Who? Acute cases, congenital cases, immunocompromised, chronic cases under 16-18 yrs old
• What? Nifurtimox and benznidazole

Overlapping domestic and sylvatic infection cycles