| Disease/Syndrome |
American Trypanosomiasis |
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| Category |
Infection, Travel |
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| Acute/Chronic |
Subacute |
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| Synonyms |
Chagas disease; Trypanosoma cruzi infection; |
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| Biomedical References |
Search PubMed |
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| Comments |
FINDINGS: There are two distinct syndromes: acute and chronic (late sequelae). Acute disease usually affects children, in whom the diagnosis is seldom made. Cases are usually mild, but a small proportion of patients die from myocarditis and meningoencephalitis. Survivors enter a latent phase that lasts for years or decades, and 20-40% of these develop chronic Chagas disease. Patients with chronic disease develop heart conduction abnormalities leading to congestive heart failure and syncope and autonomic nervous disease leading to megaesophagus (dysphagia) and megacolon (constipation and bowel obstruction). [Merck Manual, p. 1572-3] EPIDEMIOLOGY: Reservoirs include humans and over 150 species of wild and domestic animals. Travelers to endemic areas should avoid sleeping in poorly constructed houses that may harbor the kissing bugs in thatched roofs and other cracks and crevices. Freshly excreted bug feces contain trypanosomes that may infect humans through mucous membranes, conjunctivae, and skin abrasions. [CCDM, p. 558] 10% to 20% of recipients may become infected after transfusion of a single unit of contaminated blood. [ID, p. 2330-3] An estimated 50,000-100,000 Latin American immigrants living in the USA have the infection. The majority of patients with chronic infection are asymptomatic. Cardiac disease usually develops in the 3rd or 4th decade of life: right bundle branch block, arrhythmias, CHF, ventricular aneurysms, and mural thrombi. [Current Consult, p. 976] |
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| Latency/Incubation |
5 days to 2 weeks after bitten by the triatomine bug (kissing bug) |
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| Diagnostic |
Wet mount and Giemsa stain of buffy coat; Serology; PCR; Culture of blood; Xenodiagnosis; [PPID, p. 3161-2] CSF: lymphocytic pleocytosis; [5-Min Neuro Consult, p. 447] |
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| ICD-9 Code |
086.2 |
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| Effective Antimicrobics |
Yes |
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| Scope |
Mexico, Central America, and South America; |
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| Reference Link |
CDC - Chagas Disease |
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| Image |
U of Wisc: Chagoma and Romano's sign |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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