Chagas disease

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Chagas disease
Photomicrograph of Giemsa-stained Trypanosoma cruzi crithidia (CDC)

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tamar Sifri [2]

Synonyms and keywords: American trypanosomiasis; Trypanosoma cruzi infection

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Chagas disease from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Life Cycle

An infected triatomine insect vector (or "kissing" bug) takes a blood meal and releases trypomastigotes in its feces near the site of the bite wound. Trypomastigotes enter the host through the wound or through intact mucosal membranes, such as the conjunctiva (1). Common triatomine vector species for trypanosomiasis belong to the genera Triatoma, Rhodnius, and Panstrongylus. Inside the host, the trypomastigotes invade cells near the site of inoculation, where they differentiate into intracellular amastigotes (2). The amastigotes multiply by binary fission (3) and differentiate into trypomastigotes, and then are released into the circulation as bloodstream trypomastigotes (4). Trypomastigotes infect cells from a variety of tissues and transform into intracellular amastigotes in new infection sites. Clinical manifestations can result from this infective cycle. The bloodstream trypomastigotes do not replicate (different from the African trypanosomes). Replication resumes only when the parasites enter another cell or are ingested by another vector. The "kissing" bug becomes infected by feeding on human or animal blood that contains circulating parasites (5). The ingested trypomastigotes transform into epimastigotes in the vector's midgut (6). The parasites multiply and differentiate in the midgut (7) and differentiate into infective metacyclic trypomastigotes in the hindgut (8). Trypanosoma cruzi can also be transmitted through blood transfusions, organ transplantation, transplacentally, and in laboratory accidents.

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