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Chagas Disease (American Trypanosomiasis)

Trypanosoma cruzi infection with chronic cardiac and digestive sequelae

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Chagas Disease (American Trypanosomiasis)?

Chagas disease is caused by the protozoan parasite Trypanosoma cruzi, endemic to Latin America with an estimated 6-7 million infected individuals globally. Transmission occurs primarily through bites of infected triatomine bugs (kissing bugs), but also via blood transfusion, organ transplantation, congenital transmission, oral ingestion of contaminated food/beverages, and laboratory accidents.

Acute infection (lasting 6-8 weeks) is often asymptomatic but may present with Romaña sign (unilateral periorbital edema), chagoma (skin chancre), fever, lymphadenopathy, and rarely myocarditis or meningoencephalitis. After acute phase, patients enter the indeterminate chronic phase (asymptomatic, normal ECG and imaging), which can persist for decades.

Chronic determinate disease develops in 20-30% of patients after 10-30 years and includes: Chagas cardiomyopathy (apical aneurysm, conduction blocks especially right bundle branch with left anterior fascicular block, ventricular arrhythmias, heart failure, sudden death) and digestive disease (megaesophagus with dysphagia and aspiration, megacolon with constipation and volvulus). Diagnosis combines serology (two different tests required), epidemiologic exposure, and clinical findings. Treatment with benznidazole or nifurtimox is most effective in acute and early chronic phases.

Symptoms

Acute phase: fever, malaise, lymphadenopathy
Romaña sign (unilateral periorbital edema)
Chagoma at site of inoculation
Chronic indeterminate: asymptomatic
Chagas cardiomyopathy: heart failure, arrhythmias, syncope
Megaesophagus: dysphagia, regurgitation, weight loss
Megacolon: chronic constipation, abdominal distension

Risk Factors

Birth or residence in endemic areas (Latin America)
Rural housing with thatched roofs and adobe walls
Mother with Chagas disease (congenital transmission)
Blood transfusion in endemic regions before screening
Organ transplantation from infected donor
Travel to endemic areas with consumption of contaminated foods (açaí juice)
Immunocompromised state (HIV, transplant) reactivation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Acute fever after travel to or living in endemic areas
  • Romaña sign or skin chancre after vector exposure
  • Cardiac symptoms in patient from endemic region
  • Dysphagia or regurgitation in suspected patient
  • Chronic constipation with megacolon imaging
  • Pre-blood donation or transplantation screening
  • Pregnancy in mother from endemic area (congenital risk)

Treatment Methods

01
Serologic confirmation with two different tests
02
ECG, echocardiography, and Holter for cardiac evaluation
03
Barium swallow and colonography for digestive evaluation
04
Benznidazole 5-7 mg/kg/day for 60 days (first-line)
05
Nifurtimox 8-10 mg/kg/day for 60-90 days (alternative)
06
Symptomatic management: pacemaker/ICD, heart failure therapy, surgery for megasyndromes
07
Lifelong follow-up for cardiac and digestive complications

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Enfeksiyon Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.