[Acute phase of Chagas disease in the Brazilian Amazon region: study of 233 cases from Pará, Amapá and Maranhão observed between 1988 and 2005].

Abstract:

:Two hundred and thirty-three cases of the acute phase of Chagas disease, from Pará, Amapá and Maranhão, were observed between 1988 and 2005. One hundred and sixty were studied retrospectively from 1988 to 2002 and seventy-three were prospectively followed up from 2003 to 2005. Among the cases studied, 78.5% (183/233) formed part of outbreaks, probably due to oral transmission (affecting a mean of 4 individuals), and 21.5% (50/233) were isolated cases. Cases were taken to be acute if they presented positive direct parasitological tests (fresh blood, thick drop or Quantitative Buffy Coat, QBC) and/or positive anti Trypanosoma cruzi IgM. Xenodiagnosis was also performed on 224 patients and blood culturing on 213. All the patients had clinical and epidemiological evaluations. The most frequent clinical manifestations were fever (100%), headache (92.3%), myalgia (84.1%), pallor (67%), dyspnea (58.4%), swelling of the legs (57.9%), facial edema (57.5%), abdominal pain (44.3%), myocarditis (39.9%) and exanthema (27%). The electrocardiogram showed abnormalities of ventricular repolarization in 38.5%, low QRS voltage in 15.4%, left-axis deviation in 11.5%, ventricular ectopic beats in 5.8%, bradycardia in 5.8%, tachycardia in 5.8%, right branch block in 4.8% and atrial fibrillation in 4.8%. The most frequently observed abnormality on the echocardiogram was pericardial effusion, in 46.2% of the cases. Thirteen (5.6%) patients died: ten (76.9%) of them due to cardiovascular involvement, two due to digestive complications and one due to indeterminate causes.

journal_name

Rev Soc Bras Med Trop

authors

Pinto AY,Valente SA,Valente Vda C,Ferreira Junior AG,Coura JR

doi

10.1590/s0037-86822008000600011

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

602-14

issue

6

eissn

0037-8682

issn

1678-9849

pii

S0037-86822008000600011

journal_volume

41

pub_type

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