1. Clinical picture: Generally at hospital, with severe disease (or not), started with fever of unknown origin. Frequent causes have not been found.
2. Epidemiological fact: Received transfusion recently (last 2 months) or transplantation (bone marrow, other organs) and has fever after, unknown causes.
3. Laboratory: Perhaps some laboratory technician saw strange pathogens in the smear, during a routine differential count. Try to identify the parasite. Ask for a fresh blood smear. If negative, ask for Strout or microhematocrit technique. Transfusional transmitted cases have easily detected parasitemias.
4. Action: If positive, the diagnosis is acute phase of Chagas disease, by transfusion or transplantation in a patient with other disease, which motivates the transfusion/transplantation. Start specific treatment.
1. Clinical picture: Several people living at the same house or neighbors who participate recently in some festivity, and used the same food, became febrile after some days. A disease transmitted by foods is suspected. Some have digestive manifestations, even with hematemesis (blood vomiting). Some patients may look severely ill. Liver tests may show alterations (bilirubins, transaminases).
2. Epidemiological fact: Endemic region or not endemic, that uses fresh foods from endemic regions.
3. Laboratory: Ask for a fresh blood smear. If negative, ask for Strout or microhematocrit technique.
4. Action: If positive, the diagnosis is acute phase of Chagas disease, by oral route. Start treatment and diagnose the other similarly affected. Direct diagnosis should be made in all the persons that eat or drink the identified food (if any identified).