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Chagas Disease

Definition


Disease: Chagas Disease Chagas Disease
Category: Infectious diseases
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Disease Definition:

The inflammatory infectious condition that is caused by a parasite found in the feces of the reduviid bug is referred to as Chagas disease. Chagas disease is diagnosed most often in children, though it can infect anyone.

Serious digestive and heart problems can be caused by untreated Chagas disease. Killing the parasite and managing signs and symptoms are the goals of treatment of Chagas disease. Additionally, this infection can be prevented by taking certain steps.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

This disease occurs in three phases: acute, intermediate and chronic. There are no signs or symptoms in the intermediate stage, which occurs 8 to 10 weeks after the infection. Although many people don't experience symptoms until the chronic stage, but if they do, symptoms in the acute and chronic phases can range from mild to severe.

Acute phase:
This phase of Chagas disease may be symptom-free, and it lasts for weeks or months. Signs and symptoms are usually mild when they occur, and they may include the following:
 

  • Enlargement of the liver or spleen
  • Vomiting, nausea or diarrhea
  • Fatigue
  • Body aches
  • Swelling at the infection site
  • Headache
  • Loss of appetite
  • Fever
  • Swollen glands
  • Rash

 

Although the infection persists and advances to the chronic phase when it is left untreated, signs and symptoms that develop during the acute phase usually disappear on their own.

Chronic phase:
In some cases, signs and symptoms of the chronic phase of Chagas disease may occur 10 to 20 years after the initial infection, or in other cases, they may never occur. However, in severe cases, the signs and symptoms of Chagas disease may include:

  • Sudden cardiac arrest
  • Inflamed, enlarged heart (cardiomyopathy)
  • Abdominal pain or constipation due to enlarged colon
  • Congestive heart failure
  • Difficulty swallowing due to enlarged esophagus
  • Irregular heartbeat


When living in or having traveled to an area at risk of Chagas disease and having signs and symptoms of the condition such as fatigue, rash, nausea, fever, body aches and swelling at the infection site, one should see the doctor.

Causes:

The parasite Trypanosoma cruzi is the cause of Chagas disease. Various species of bloodsucking insects that are known as triatomine insects or reduviid bugs transmit T. cruzi to humans. When these insects ingest blood from an animal already infected with the parasite, they become infected by T. cruzi. Because of their tendency to feed on faces, they are also called "kissing bugs".

The reduviid bugs commonly live in mud, thatch or adobe huts. They often feed on sleeping humans, and during the day, they hide in crevices in the roof or walls.

The skin of the infected person becomes irritated because when reduviid bugs bite humans they defecate, passing the T. cruzi parasites in their feces. The parasites can enter the body through a cut or scratch, mouth, eyes or the wound from the reduviid bug's bite. They may enter the body by scratching or rubbing the bite site, and they multiply and spread once they enter the body.

Some of the other ways through which someone may become infected are:
 

  • Spending time in a forest that houses infected wild animals, such as opossums and raccoons
  • Being with an infected pet
  • Having a blood transfusion containing infected blood
  • Being born to a woman infected with T. cruzi
  • Getting an organ transplant containing infected blood
  • Eating uncooked food contaminated with feces from infected reduviid bugs
  • Working in a laboratory where there might be an accidental contact with the parasite.

 
One's risk of getting Chagas disease may increase when living in a residence that contains reduviid bugs.

Complications

Complications:

Serious heart or digestive complications may occur if Chagas disease progresses to the chronic phase. These complications may include the following:
 

  • Enlargement of the colon (megacolon): Causing abdominal pain, severe constipation and distension, megacolon occurs when the colon becomes abnormally dilated.

 

  • Enlargement of the esophagus (megaesophagus): The abnormal widening (dilation) of the esophagus, which may cause difficulty with digestion and even swallowing, is the cause of this rare condition.

 

  • Heart failure: When the heart becomes so weak or stiff that it can't pump enough blood to meet the body's needs, heart failure occurs.

Treatments:

Killing the parasite and managing signs and symptoms are the goals of treatment for Chagas disease. The prescription medications nifurtimox and benznidazole may be helpful during the acute phase of Chagas disease. In the regions that are usually affected by Chagas disease, both drugs are available.

However, medications aren't effective for curing the disease once Chagas disease reaches its chronic phase. And in that case, the specific signs and symptoms determine the treatment:

  • Digestive-related complications: Medications, corticosteroids, diet modification or even surgery in severe cases, may be included in the treatment.

 

  • Heart-related complications: A pacemaker or other devices to regulate the heart rhythm of the patient, surgery, or even heart transplant may be included in the treatment.

Prognosis:

Not Available

Expert's opinion

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Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

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