Daily Bolus of LR: Chagas Disease

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January 31, 2012 by dailybolusoflr

Chagas Disease

 

·         The most common cause of myocarditis in South and Central America

·         Caused by T. Cruzi infection

·         Rarely is Romana’s sign seen, which is pathognomonic for the disease (unilateral painless periorbital edema  after the conjunctival surface is compromised and allows entrance of the trypomastigote of T. Cruzi )

·         The trypomastigote migrates and takes up residence in the cardiac muscle, autonomic ganglia of the heart, esophagus and colon

·         Flu like illness presents in the acute setting with fever, malaise, but also with facial and extremity edema, hepatosplenomegaly, and lymphadenopathy    

o   Usually self-resolved after 1-2 months

·         Chronic illness occurs in about 25% of patients

o   Patients can present with myocarditis and global cardiac dysfunction with complications of CHF, thromboembolic disease as well as cardiac conduction abnormalities

o   Patients should have AICDs implanted and treatment with antitrypanosomal medication can be considered in conjunction with the CDC

 

Ref: Rosen’s 7th ed

 

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