Chagas disease

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Chagas disease, also referred astrypanosomiasis, is a tropical parasitic infection ~~caused by a protozoan,~~ ~~Tripanosoma cruzi~~~~. It is commonly transmitted to humans by an insect vector. Although it has~~with a wide spectrum of clinical manifestations, since it can virtually affect any organ, but there are characteristic radiological features.

Radiographic featuresPathology

~~Radiographic features of~~ Chagas disease ~~can be seen on barium studies, plain films, CT and MRI~~caused by a protozoan, Trypanosoma cruzi. It is commonly transmitted to humans by an insect vector.

Cardiac manifestations

These

are common in endemic regions. The pathogenesis is unclear since the parasite is not often found in heart tissue on autopsy, and an immunologic myocarditis has been suggested as the origin of the cardiac disease.

Symptoms begin with an acute myocarditis, after which patients enter a latent phase. ~~~20~~Approximately 20% of these patients experience gradual fibrous replacement of myofibrils and Purkinje fibers. Eventually, dilated cardiomyopathy ensues, with ~~arrhythmias~~ arrhythmias and heart block. Segmental wall motion abnormalities and apical aneurysm may occur. Heart transplantation has been performed for end stage disease.⁶.

Gastrointestinal manifestations

10-15% of patients are affected with chronic infection, and manifestations include

esophageal dismotility and megaesophagus (aperistaltism and dilatation)
megaduodenum and small bowel dilatation
megacolon: left colon and rectosigmoid colon are more commonly affected

Genitourinary manifestations

Chagas disease is also known to cause dilatation of the ureter.

CNS manifestations

meningoencephalitis

Radiographic features

Radiographic features of Chagas disease can be seen on barium studies, plain films, CT and MRI.

MRI

On cardiac MR, delayed enhancement has been reported in the left ventricular wall in both CAD and non-CAD distributions. The delayed enhancement is progressive over time, and increasing delayed enhancement corresponds with decreasing cardiac performance.⁷

~~Gastrointestinal manifestations~~~~, affecting 10-15% of patients with chronic infection, include :~~

~~esophageal dismotility~~ ~~and~~ ~~megaesophagus~~ ~~(aperistaltism and dilatation)~~
~~megaduodenum~~ ~~and~~ ~~small bowel dilatation~~
~~megacolon~~ ~~: left colon and rectosigmoid colon are more commonly affected~~

~~Chagas disease is also known to cause dilatation of the ureter and~~ ~~meningoencephalitis~~.

History and etymology

Named afterCarlos Justiniano Ribeiro Chagas (1879-1934), a Brazilian physician who ~~completely~~ completely described ~~this~~ this infectious disease: the pathogen, the vector, the host, the clinical manifestations and its epidemiology.

-<p><strong>Chagas disease</strong>, also referred as <strong>trypanosomiasis</strong>, is a tropical parasitic infection caused by a protozoan, <em>Tripanosoma cruzi</em>. It is commonly transmitted to humans by an insect vector. Although it has a wide spectrum of clinical manifestations, since it can virtually affect any organ, there are characteristic radiological features.</p><h4>Radiographic features</h4><p>Radiographic features of Chagas disease can be seen on barium studies, plain films, CT and MRI.</p><p><strong>Cardiac manifestations</strong> are common in endemic regions. The pathogenesis is unclear since the parasite is not often found in heart tissue on autopsy, and an immunologic myocarditis has been suggested as the origin of the cardiac disease.</p><p>Symptoms begin with an acute <a href="/articles/myocarditis">myocarditis</a>, after which patients enter a latent phase. ~20% of these patients experience gradual fibrous replacement of myofibrils and Purkinje fibers. Eventually, dilated cardiomyopathy ensues, with arrhythmias and heart block. Segmental wall motion abnormalities and apical aneurysm may occur. Heart transplantation has been performed for end stage disease.<sup>6</sup></p><p>On cardiac MR, delayed enhancement has been reported in the left ventricular wall in both CAD and non-CAD distributions. The delayed enhancement is progressive over time, and increasing delayed enhancement corresponds with decreasing cardiac performance.<sup>7</sup></p><p><strong>Gastrointestinal manifestations</strong>, affecting 10-15% of patients with chronic infection, include :</p><ul>
+<p><strong>Chagas disease</strong>, also referred as <strong>trypanosomiasis</strong>, is a tropical parasitic infection with a wide spectrum of clinical manifestations, since it can virtually affect any organ, but there are characteristic radiological features.</p><h4>Pathology</h4><p>Chagas disease caused by a protozoan, <em>Trypanosoma cruzi</em>. It is commonly transmitted to humans by an insect vector.</p><h5>Cardiac manifestations</h5><p>These are common in endemic regions. The pathogenesis is unclear since the parasite is not often found in heart tissue on autopsy, and an immunologic myocarditis has been suggested as the origin of the cardiac disease.</p><p>Symptoms begin with an acute <a href="/articles/myocarditis">myocarditis</a>, after which patients enter a latent phase. Approximately 20% of these patients experience gradual fibrous replacement of myofibrils and Purkinje fibers. Eventually, dilated cardiomyopathy ensues, with arrhythmias and heart block. Segmental wall motion abnormalities and apical aneurysm may occur. Heart transplantation has been performed for end stage disease <sup>6</sup>.</p><h5>Gastrointestinal manifestations</h5><p>10-15% of patients are affected with chronic infection, and manifestations include</p><ul>
~~-<a href="/articles/megacolon">megacolon</a> : left colon and rectosigmoid colon are more commonly affected </li>~~
-</ul><p>Chagas disease is also known to cause dilatation of the ureter and <a href="/articles/meningoencephalitis">meningoencephalitis</a>.</p><h4>History and etymology</h4><p>Named after <strong>Carlos Justiniano Ribeiro Chagas</strong> (1879-1934), a Brazilian physician who completely described this infectious disease: the pathogen, the vector, the host, the clinical manifestations and its epidemiology.</p><h4>See also</h4><ul><li><a href="/articles/achalasia">achalasia</a></li></ul>
+<a href="/articles/megacolon">megacolon</a>: left colon and rectosigmoid colon are more commonly affected </li>
+</ul><h5>Genitourinary manifestations</h5><p>Chagas disease is also known to cause dilatation of the <a href="/articles/ureter">ureter</a>.</p><h5>CNS manifestations</h5><ul><li><a href="/articles/meningoencephalitis">meningoencephalitis</a></li></ul><h4>Radiographic features</h4><p>Radiographic features of Chagas disease can be seen on barium studies, plain films, CT and MRI.</p><h5>MRI</h5><p>On cardiac MR, delayed enhancement has been reported in the left ventricular wall in both CAD and non-CAD distributions. The delayed enhancement is progressive over time, and increasing delayed enhancement corresponds with decreasing cardiac performance <sup>7</sup>.</p><h4>History and etymology</h4><p>Named after <strong>Carlos Justiniano Ribeiro Chagas</strong> (1879-1934), a Brazilian physician who completely described this infectious disease: the pathogen, the vector, the host, the clinical manifestations and its epidemiology.</p><h4>See also</h4><ul><li><a href="/articles/achalasia">achalasia</a></li></ul>