Cardiopatía Chagásica en un escolar: Reporte de caso

Abstract

ResumenIntroducción: La enfermedad de Chagas (ECh) o tripanosomiasis americana es una enfermedad transmitida principalmente por insectos hematófagos detectados en zonas rurales y urbanas desde México hasta Argentina. De acuerdo a la Organización Panamericana de la Salud, entre 7,7 y 10 millones de personas cursan con infección crónica. La ECh es causada por el protozoario flagelado Trypanosoma cruzi. Posterior al contacto inicial con el vector, la fase aguda es comúnmente seguida por una fase silente que dura 15-20 años antes de debutar con manifestaciones cardíacas, neurológi-cas o gastrointestinales. Objetivo: Analizar el curso clínico atípico de un caso de cardiopatía chagásica en un paciente pediátrico del sureste de México. Caso clínico: El paciente consultó al desarrollar un chagoma en la pierna izquierda. Cinco meses después, se observó en su electrocardiograma una taquicardia sinusal y un crecimiento auricular izquierdo con ondas P anchas e intervalo QT prolongado. En la radiografía de tórax se observó cardiomegalia (índice cardiotorácico = 0,52); en el ecocardiograma transtorácico mostró dilatación del atrio y ventrículo izquierdos. Conclusión: Es importante realizar evaluaciones cardíacas oportunas en pacientes pediátricos con ECh, pues no debe asumirse que cursarán con una fase silente o que debutarán tardíamente con cardiopatía. Keywords:Chagas Cardiomyopathy; Trypanosoma cruzi; Chagas Disease; Cardiomegaly Abstract Introduction: Chagas disease also known as American Trypanosomiasis is mainly caused by haematophagous insects widely distributed from Mexico to Argentina. According to the Panamerican Health Organization, 7.7 to 10 million people are living with chronic infection. Chagas disease is caused by Trypanosoma cruzi, a protozoan transmitted by triatomine vectors. After an initial acute phase, Chagas is followed by a silent phase that lasts 15-20 years before debuting with cardiac, neurological or gastrointestinal manifestations. Objective: To analyze the atypical clinical course

Oral Trypanosoma cruzi Transmission Resulting in Advanced Chagasic Cardiomyopathy in an 11-Month-Old Male

“…A 7-month-old child with suspected vectoral transmission presented with acute Chagas myocarditis rapidly proceeding to death: this case never received Benznidazole, and diagnosis was not made until postmortem [ 19 ]. A 7-year-old child with vectoral transmission developed Chagas cardiomyopathy 3 months after a known triatomine exposure (chagoma presence); however, the exact timing of initial T. cruzi infection was unknown and speculated to have previously occurred due to epidemiologic family data [ 20 ]. A surveillance study in Mexico identified 14 cases aged 5–18 years with a history of vectoral transmission that presented with cardiomyopathy [ 21 ], providing further evidence that children can develop cardiomegaly within a short duration after infection.…”

Modulation of Host Cell Apoptosis byTrypanosoma cruzi: Repercussions in the Development of Chronic Chagasic Cardiomyopathy

“…Recent studies performed in children and teenagers from endemic areas in Mexico suggest that the time for the outcome of the CCC symptoms is shorter, months in some cases. Therefore, more research is required to clarify this aspect [42,43].…”