🪳 Chapter 333 · Chagas Disease (American Trypanosomiasis)

Nelson Textbook of Pediatrics 22nd Edition | Trypanosoma cruzi is transmitted by reduviid bugs (kissing bugs). Acute phase (often asymptomatic): chagoma, Romaña sign (unilateral periorbital edema), fever, lymphadenopathy, hepatosplenomegaly. Chronic phase (years later): cardiomyopathy (dilated, arrhythmias, apical aneurysm) and megaviscera (megaesophagus, megacolon). Congenital transmission occurs. Diagnosis: acute — blood smear (trypomastigotes); chronic — serology (ELISA, IHA). Treatment: benznidazole or nifurtimox (best in acute and congenital disease; limited benefit in chronic).