Chagas' disease

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Chagas' disease (American trypanosomiasis) is caused by Trypanosoma cruzi a protozoan transmitted by blood sucking insects of the genus Triatoma such as the kissing bug Triatoma infestans.

Presentation

  • Insidious usually
    • 10 to 30% develop after 15 to 30 years
      • Chagas' cardiomyopathy
        • Right bundle branch block or left anterior hemiblock usually first
        • Biventricular failure
        • LV apical aneurysm
        • Arrythmias
      • Dysphagia (Chagas' megaoesophagus)
      • Constipation ((Chagas' megacolon)
  • Occassionally acute

Treatment

  • Prevention (ie vector control by insecticides and environment)
  • Mainly symtomatic but:
  • Benznidazole for 60 days elminates infection in 60% infected children [1]
  • Nifurtimox also has an evolving place in therapy.

References

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