Which physical findings are characteristic of acute Chagas disease (American trypanosomiasis)?

Updated: Apr 26, 2019
  • Author: Louis V Kirchhoff, MD, MPH; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Symptoms of acute Chagas disease may include malaise, anorexia, myalgia, and headache, but many recently infected persons are asymptomatic.

Intermittent fevers occur, but they do not follow a specific pattern.

Some patients have lesions at the portal of entry of the parasites. Romaña sign (unilateral painless periorbital and palpebral edema) occurs when the parasites have contaminated the conjunctivae. Romaña sign is viewed as a classic sign of acute Chagas disease but develops in few newly infected persons. A chagoma, which is an indurated inflammatory skin lesion, may develop when parasites enter through a break in the skin. Romaña sign and chagomas may persist for several weeks. The lymph nodes that drain either of these lesions may be enlarged.

Hepatomegaly and splenomegaly may occur in children with acute Chagas disease, often accompanied by generalized lymphadenopathy.

Varying degrees of generalized edema may occur in acutely infected persons, particularly children.

Some patients with acute T cruzi infection develop a nonpruritic morbilliform rash called schizotrypanides.

Persistent tachycardia may be present.

Signs of acute myocarditis and resulting heart failure may develop in a small minority of patients with acute Chagas disease. [51, 52, 53]

Neurologic dysfunction may develop in acutely infected children with meningoencephalitis. [115]


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