Old and new challenges in Chagas disease

Summary Chagas disease, caused by the parasite Trypanosoma cruzi , is a neglected disease, which can lead to cardiomyopathy, arrhythmias, megaviscera, and more rarely, polyneuropathy in up to 30–40% of patients around 20 to 30 years after acute infection. Although it is endemic in the Americas, glob...

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Bibliographic Details
Published in:The Lancet infectious diseases 2015-11, Vol.15 (11), p.1347-1356
Main Authors: Pérez-Molina, Jose A, Dr, Perez, Angela Martinez, MD, Norman, Francesca F, MBBS, Monge-Maillo, Begoña, PhD, López-Vélez, Rogelio, PhD
Format: Article
Language:English
Subjects:
Adult
Antibodies, Protozoan - blood
Blood & organ donations
Chagas Disease - diagnosis
Chagas Disease - drug therapy
Chagas Disease - epidemiology
Chagas Disease - pathology
DNA, Protozoan - genetics
DNA, Protozoan - isolation & purification
Drug therapy
Emigrants and Immigrants
Enzyme-Linked Immunosorbent Assay
Female
Fluorescent Antibody Technique, Indirect
HIV
Human immunodeficiency virus
Humans
Infections
Infectious Disease
Infectious diseases
Mortality
Neglected Diseases - diagnosis
Neglected Diseases - drug therapy
Neglected Diseases - epidemiology
Neglected Diseases - pathology
Parasites
Patients
Polymerase Chain Reaction
Spain
Substance abuse treatment
Transplants & implants
Trypanosoma cruzi
Trypanosoma cruzi - genetics
Trypanosoma cruzi - immunology
Trypanosoma cruzi - isolation & purification
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Summary:Summary Chagas disease, caused by the parasite Trypanosoma cruzi , is a neglected disease, which can lead to cardiomyopathy, arrhythmias, megaviscera, and more rarely, polyneuropathy in up to 30–40% of patients around 20 to 30 years after acute infection. Although it is endemic in the Americas, global population movements mean that it can be located wherever migrants from endemic areas settle. The disease was first described 100 years ago and still challenges clinicians worldwide, since diagnostic, therapeutic, and prognostic methods remain insufficient. Furthermore, factors such as HIV co-infection, immunosuppressive drugs, transplantation, and neoplastic disease can alter the natural course of the infection. We present the case of a Bolivian woman with chronic T cruzi infection diagnosed at our clinic in Madrid, Spain, who subsequently developed non-Hodgkin lymphoma. Our report illustrates the challenges of an increasingly common infection seen in non-endemic countries, and highlights both daily management dilemmas and associated difficulties that arise.
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(15)00243-1