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Home arrow Economics arrow American Trypanosomiasis Chagas Disease, Second Edition: One Hundred Years of Research

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Laboratory acquired infection

  • 1. Clinical picture: Normal person working in a health service, laboratory, or research institution start with fever of unknown origin. Usual causes have been discarded.
  • 2. Epidemiological fact: Works with reduviid bugs, or with T. cruzi, in cultures, mice, or other animals. May be working in a nonendemic region. Surgeon or technician of necropsy personnel.
  • 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 laboratory accident. Start treatment and collect a sample of blood at once. Perhaps in endemic regions, the worker is already infected.

Reactivation of chronically infected

  • 1. Clinical picture: Patient with known HIV infection or with diagnosed cancer or other disease (autoimmune) which requires, as part of the treatment, large doses of corticoid or other immunosuppressors. During the course of the disease or the treatment, not expected skin lesions and/or nervous system involvement, which was not present, mainly with loss of consciousness. Any other not predicted clinical manifestation.
  • 2. Epidemiological fact: Has had Chagas disease diagnosed years ago, or was born/lived in endemic areas for Chagas disease.
  • 3. Laboratory: Ask for a fresh blood smear. If negative, ask for Strout or microhematocrit technique.
  • 4. Action: If parasitological tests are positive, the diagnosis is reactivation of chronic phase of Chagas disease, by immune suppression, which is in fact an acute phase, because the criteria of having easily detectable parasites is fulfilled. Start treatment and collect a sample of blood at once for serology. This serology should be positive, because the patient was in the chronic phase.142

The congenital route is a special situation that behaves as an acute phase and is

described in other chapter.

 
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