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

Authors

  • Helena Rangel Esper Hospital Municipal, Santarém
  • Vera Lucia Teixeira de Freitas Universidade de São Paulo, Faculdade de Medicina https://orcid.org/0000-0003-1112-081X
  • João Guilherme Pontes Lima Assy Hospital Municipal, Santarém
  • Erika Yoshie Shimoda Universidade de São Paulo, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM 48)
  • Olivia Campos Pinheiro Berreta Hospital Municipal, Santarém
  • Marta Heloisa Lopes Universidade de São Paulo, Faculdade de Medicina
  • Francisco Oscar Siqueira França Universidade de São Paulo, Faculdade de Medicina

DOI:

https://doi.org/10.1590/s1678-9946201961027

Keywords:

Acute Chagas disease, Trypanosoma cruzi, qPCR, Bacaba palm fruit, Children

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.

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Published

2019-08-09

How to Cite

Esper, H. R., Freitas, V. L. T. de, Assy, J. G. P. L., Shimoda, E. Y., Berreta, O. C. P., Lopes, M. H., & França, F. O. S. (2019). Fatal evolution of acute Chagas disease in a child from Northern Brazil: factors that determine poor prognosis. Revista Do Instituto De Medicina Tropical De São Paulo, 61, e27. https://doi.org/10.1590/s1678-9946201961027

Issue

Section

Case Report