Chagas disease: Difference between revisions
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==Background== | ==Background== | ||
*Endemic in rural parts of South | *Endemic in rural parts of Cental and South America | ||
**Rare cases found in Southern United States | **Rare cases found in Southern United States | ||
*Caused by the parasite [[wikipedia:trypanosoma cruzi|trypanosoma cruzi]] | *Caused by the parasite [[wikipedia:trypanosoma cruzi|trypanosoma cruzi]] | ||
**Vector: Reduviid (kissing bug) | |||
**The parasite is transmitted in the feces of the host vector | **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 | ***When the vector bites, it also defecates and the parasites enter the blood stream through the bite wound | ||
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**Fever, fatigue, myalgias, headache, anorexia, vomiting, diarrhea | **Fever, fatigue, myalgias, headache, anorexia, vomiting, diarrhea | ||
*Serious complications | *Serious complications | ||
**Myocarditis, encephalitis | **Myocarditis, arrhythmia, encephalitis | ||
===Chronic phase=== | ===Chronic phase=== | ||
*Between 20-40% of patients will develop chronic complications | *Between 20-40% of patients will develop chronic complications | ||
*'''Cardiac complications''' | *'''Cardiac complications''' | ||
**Dilated cardiomyopathy | **Dilated cardiomyopathy (CHF) | ||
**Dysrhythmias | **Dysrhythmias | ||
*'''GI complications''' | *'''GI complications''' | ||
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**Megacolon | **Megacolon | ||
**Achalasia | **Achalasia | ||
**Hepatosplenomegaly (secondary to HF) | |||
*'''Neuro symptoms''' | *'''Neuro symptoms''' | ||
**Neuritis | **Neuritis | ||
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==Work-Up== | ==Work-Up== | ||
*EKG | *EKG | ||
*Liver Enzymes | |||
*Blood smear | *Blood smear | ||
*PCR, ELISA, Etc | *PCR, ELISA, Etc | ||
==Treatment== | ==Treatment== | ||
*Benznidazole | *Benznidazole or Nifurtimox | ||
*Symptomatic treatment | *Symptomatic treatment | ||
Revision as of 02:10, 13 January 2015
Background
- 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
- Fever, fatigue, myalgias, headache, anorexia, vomiting, diarrhea
- Serious complications
- Myocarditis, arrhythmia, encephalitis
Chronic phase
- Between 20-40% of patients will develop chronic complications
- Cardiac complications
- Dilated cardiomyopathy (CHF)
- Dysrhythmias
- GI complications
- Megaesophagus
- Megacolon
- Achalasia
- Hepatosplenomegaly (secondary to HF)
- Neuro symptoms
- Neuritis
Diagnosis
- Blood smear
- Can visualize parasites
- Blood tests
- PCR, ELISA, immunoflorescence
Work-Up
- EKG
- Liver Enzymes
- Blood smear
- PCR, ELISA, Etc
Treatment
- Benznidazole or Nifurtimox
- Symptomatic treatment