Epidemiology

Etiology

• Pathogen: Trypanosoma cruzi
• Route of infections
  • Vector transmission
    • Numerous triatomine species of the Reduviidae family (also called kissing bug because it typically bites around the mouth)
      • They hide in the cracks of houses and usually bite individuals in their sleep.
    • T. cruzi is shed in the feces of the reduviid bug; feces is then rubbed into the bite site while scratching.

Pathophysiology

Clinical features

• Acute phase
  • Cutaneous manifestations
    • Chagoma: inflammatory edema at the bite site (usually in the face)
    • Romana sign: unilateral painless edema of the eyelids and periocular tissue
      • Romana sign is seen when the portal of entry of T. cruzi is the conjunctiva. Patients may also present with ipsilateral conjunctivitis and preauricular lymph node enlargement.

Diagnostics

Best initial test: direct visualization of T. cruzi trypomastigotes in thin and thick peripheral blood smears using a Giemsa stain

Treatment