Diagnosis and Treatment of Congenital Chagas Disease in a Premature Infant

Abstract

Chagas disease is caused by Trypanosoma cruzi, a protozoan parasite transmitted by Triatominae insects, predominantly in rural areas of Latin America [ 1]. Other important modes of transmission include blood transfusion from an infected donor and oral transmission, reported in the Amazon region of South America, and from an infected mother to her unborn child. If untreated, Chagas disease can cause serious cardiac manifestations in chronically infected patients, including heart failure, stroke, and sudden death. The World Health Organization has estimated that more than 5 million people are infected with T cruzi in Latin America, and approximately 1.2 million of them are women of child-bearing age [ 1]. The risk of congenital transmission is estimated to be 5% in endemic regions of Latin America. On the basis of immigration estimates and seroprevalences reported by countries of origin, an estimated 300 000 people with chronic Chagas disease are living in the United States. On the basis of that estimate and reported congenital transmission rates, the US Centers for Disease Control and Prevention (CDC) has estimated that 63 to 315 babies are born every year with congenitally transmitted Chagas disease [ 2]. With the migration of people from endemic regions of Latin America to other parts of the world, including the United States, healthcare providers should consider this disease as a possibility in patients at risk and conduct a thorough evaluation to confirm the diagnosis of Chagas disease and provide appropriate treatment when indicated.