title: [Acute Chagas disease in Colombia: a rarely suspected disease. Report of 10 cases presented during the 2002-2005 period].
abstract: BACKGROUND
  In Colombia, reported cases of acute Chagas disease are sporadic.
  
  
  OBJECTIVE
  Ten cases were described that had been reported to the Parasitology Laboratory of the Colombian National Health Institute between December 2002 and November 2005.
  
  
  METHODS
  Information from clinical records, epidemiological report forms, laboratory and blood tests was collated. In addition the following data were compiled: demographic variables, clinical findings, results of laboratory tests and other exams (such as peripheral blood smears), IFAT for IgG antibodies, isolation in culture medium, inoculation in mice, polymerase chain reaction tests and isoenzyme eletrophoresis.
  
  
  RESULTS
  All the cases presented in known endemic areas for Chagas disease transmission in Colombia. Three cases were from Putumayo Province, two each from the provinces of Arauca, Casanare, Norte de Santander and one from Santander Province. The probable mode of transmission was vector-borne. Seven cases presented in adults aged 18 to 50, three in children aged 6 months to 2 years. Seven were male and three were female. The most frequent symptom was fever in nine cases. Signs of portal of entry were rare; only one patient presented a possible Romahia's sign. Three patients presented myocarditis, two acute cardiac failure and one cardiac tamponade. Parasitemia was evident in nine cases; five had positive IgG serological tests; five cases were confirmed through parasite isolation; isoenzyme electrophoresis showed Trypanosoma cruzi group I.
  
  
  CONCLUSIONS
  Clinical variability prevailed. In none of the cases was a clinical diagnosis suspected. The diagnosis was made and confirmed through laboratory tests alone. The results highlight the importance of including this disease in the differential diagnosis of febrile syndrome in endemic regions due to its good response to etiological treatment and thereby preventing its progression to the chronic phase.
authors.affiliation: Grupo Parasitología, Instituto Nacional de Salud, Bogotá, D.C., Colombia. rnichols@ins.gov.co
authors.forename: Rubén Santiago
authors.initials: RS
authors.lastname: Nicholls
authors.forename: Zulma Milena
authors.initials: ZM
authors.lastname: Cucunubá
authors.forename: Angélica
authors.initials: A
authors.lastname: Knudson
authors.forename: Astrid Carolina
authors.initials: AC
authors.lastname: Flórez
authors.forename: Marleny
authors.initials: M
authors.lastname: Montilla
authors.forename: Concepción Judith
authors.initials: CJ
authors.lastname: Puerta
authors.forename: Paula Ximena
authors.initials: PX
authors.lastname: Pavía
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000818:Animals; D014355:Chagas Disease / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D051379:Mice; D008875:Middle Aged; D014349:Trypanosoma cruzi / Q000378:metabolism / Q000472:pathogenicity
vernacular_title: Enfermedad de Chagas aguda en Colombia, una entidad poco sospechada. Informe de 10 casos presentados en el periodo 2002 a 2005.