Fatal acute Chagas disease by Trypanosoma cruzi DTU TcI, Ecuador

BMC Infectious Diseases

Jaime A. Costales¹  Yosselin Vicuña²  Gabriela Segovia²  Angel Guevara²  William Cevallos²  Manuel Calvopina³ 

[1] Centro de Investigación para la Salud en América Latina (CISeAL), Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador;Instituto de Biomedicina, Carrera de Medicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador;OneHealth Research Group, Carrera de Medicina, Facultad de Ciencias de la Salud, Universidad de Las Américas (UDLA);

关键词: Trypanosoma cruzi;    TcI;    DTU;    Fatal acute Chagas disease;    Ecuador;   

DOI  :  10.1186/s12879-020-4851-0

来源: DOAJ

【 摘 要 】

Abstract Background Chagas disease is caused by the haemoflagellate protozoan Trypanosoma cruzi. Currently, T. cruzi recognizes seven discrete typing units (DTUs): TcI to TcVI and Tcbat. The genetic diversity of T. cruzi is suspected to influence the clinical outcome. Acute clinical manifestations, which include myocarditis and meningoencephalitis, are sometimes fatal; occur most frequently in children and in immunocompromised individuals. Acute disease is often overlooked, leading to a poor prognosis. Case presentation A 38-year-old man from a subtropical area of the Andes mountains of Ecuador was hospitalized after 3 weeks of evolution with high fever, chills, an enlarged liver, spleen, and lymph nodes, as well as facial edema. ECG changes were also observed. T. cruzi was identified in blood smears, culture and amplification of DNA by PCR. Tests for anti-T. cruzi IgG and IgM and HIV were negative. Molecular typing by restriction fragment length polymorphism (PCR-RFLP) determined the parasite to DTU TcI. In the absence of a timely anti-T. cruzi medication, the patient died. Conclusions This is a case of severe pathogenicity and the virulence of a DTU TcI strain in an adult patient. The severe acute Chagas disease was probably overlooked due to limited awareness and its low incidence. Our findings suggest that T. cruzi DTU TcI strains circulating in Ecuador are capable of causing fatal acute disease. Early diagnosis and prompt treatment is of paramount importance to avoid fatalities in acute infections.

【 授权许可】

Unknown