Fatal evolution of acute Chagas disease in a child from Northern Brazil: factors that determine poor prognosis

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Helena Rangel Esper, Vera Lucia Teixeira de Freitas, João Guilherme Pontes Lima Assy, Erika Yoshie Shimoda, Olivia Campos Pinheiro Berreta, Marta Heloisa Lopes, Francisco Oscar Siqueira França
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2019
• Subjects: Acute Chagas disease; Trypanosoma cruzi; qPCR; Bacaba palm fruit; Children; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/s1678-9946201961027; https://doaj.org/article/a5bc1830112e4ca28adc3f2011d69d30

ABSTRACT Trypanosoma cruzi is the causative agent of Chagas disease. Nowadays, the transmission in Brazil occurs mainly by oral ingestion of contaminated food that has been associated with more severe clinical manifestations. We report a case of Acute Chagas disease caused by oral transmission in a child from Northern Brazil. In the hospital admission, physical examination showed tachycardia, hepatomegaly, bipalpebral edema and anasarca. Trypanosoma cruzi trypomastigotes were found in microscopy during blood cell count. Twenty-three days before hospitalization, the child had ingested the “bacaba palm fruit's wine”. Even with the appropriate diagnosis and starting of treatment, she did not survive. Quantitative analysis of Trypanosoma cruzi DNA in a blood sample resulted in 54,053.42 parasite equivalents/mL and the DTU TcIV was identified. The outcome may have been determined by several factors, including the delay to seek a medical service beyond the high parasitemia, detected by qPCR. DTU TcIV could also have influenced the natural history of the disease.