Chagas’ disease /chag″əs/ [Carlos Chagas, Brazilian physician, 1879–1934] , a protozoal infection caused by Trypanosoma cruzi, transmitted to humans by certain species of bloodsucking reduviid (triatomine) bugs, which are found only in the Americas and mainly in poorer areas of Latin America. Also called American trypanosomiasis, Brazilian trypanosomiasis, South American trypanosomiasis, Cruz trypanosomiasis, Trypanosoma cruzi, Chagas-Cruz disease. See also trypanosomiasis. ▪ OBSERVATIONS: The most recognized sign of acute infection, which is common in children and rare in adults, is a swelling of the eyelids on the side of the face near the insect bite, known as Romaña’s sign. The acute form is also marked by a lesion at the site of the bite, fever, weakness, enlarged spleen and lymph nodes, edema of the face and legs, and tachycardia. This form resolves within 4 months unless complications, such as encephalitis, develop. The chronic form may be manifested by cardiomyopathy or by dilation of the esophagus or colon. Often, infections are asymptomatic. ▪ INTERVENTIONS: Treatment with nifurtimox and benznidazole is, at best, only partially effective. ▪ PATIENT CARE CONSIDERATIONS: It may occur in acute or chronic form, both of which can be asymptomatic or life threatening. Natural reservoirs include dogs, armadillos, and rodents.
