title: Emerging acute Chagas disease in Amazonian Brazil: case reports with serious cardiac involvement.
abstract: Four cases of serious cardiac attacks by autochthonous Trypanosoma cruzi infection from the Brazilian Amazon are reported; three of them occurred in micro-epidemic episodes. The manifestations included sudden fever, myalgia, dyspnea and signs of heart failure. Diagnosis was confirmed by specific exams, especially QBC (Quantitative Buffy Coat) and natural xenodiagnosis. Despite treatment with benznidazol, three patients died with serious myocarditis, renal failure and cardiac tamponade. The authors call attention to the emergence of this disease and reveal a previously unknown pathogenicity of T. cruzi strains in this area, added to a non-usual transmission form.
authors.affiliation: Parasitology Department, Evandro Chagas Institute, BR 316 Highway, Ananindeua City, Pará, Brazil. ayece@iec.pa.gov.br
authors.forename: Ana Yecê das Neves
authors.initials: AY
authors.lastname: Pinto
authors.forename: Sebastião Aldo da Silva
authors.initials: SA
authors.lastname: Valente
authors.forename: Vera da Costa
authors.initials: Vda C
authors.lastname: Valente
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000818:Animals; D001938:Brazil; D002305:Cardiac Tamponade / Q000469:parasitology* / Q000473:pathology; D002598:Chagas Cardiomyopathy / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D021821:Communicable Diseases, Emerging / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014349:Trypanosoma cruzi / Q000302:isolation & purification; D020525:Xenodiagnosis