American Trypanosomiasis (Chagas disease)
Pathogen & transmission
Kissing (Reduvid/Triatomine) bug: antisocial: bite, then defecate on the wound
Clinical
Acute: Romana's sign (bite around eye then defecate, rub eye and infection spreads) e.g. Acute Chagas Disease Manifesting as Orbital Cellulitis, Texas, USA (Parker Hudson et al, EID, 2021)
Cardiac: Dilated Chagas cardiomyopathy
GI: Megacolon / megaoesophagus
Diagnosis
Serology
Standard diagnosis by two tests: e.g. ELISA, immunoflourescence, haemagglutination,
Microscopy
Large kinetoplast
Risk factors / Who to test?
Treatment
Benznidazole
Nifurtimox
Similar benefit in terms of treatment results, but benznidazole is considered to have better tolerability
Current treatment protocol may reduce the whole body parasite load, but rarely leads to T.cruzi eradication
Annual serology recomended
Bailey below: