title: Old and new challenges in Chagas disease.
abstract: Chagas disease, caused by the parasite Trypanosoma cruzi, is a neglected disease, which can lead to cardiomyopathy, arrhythmias, megaviscera, and more rarely, polyneuropathy in up to 30-40% of patients around 20 to 30 years after acute infection. Although it is endemic in the Americas, global population movements mean that it can be located wherever migrants from endemic areas settle. The disease was first described 100 years ago and still challenges clinicians worldwide, since diagnostic, therapeutic, and prognostic methods remain insufficient. Furthermore, factors such as HIV co-infection, immunosuppressive drugs, transplantation, and neoplastic disease can alter the natural course of the infection. We present the case of a Bolivian woman with chronic T cruzi infection diagnosed at our clinic in Madrid, Spain, who subsequently developed non-Hodgkin lymphoma. Our report illustrates the challenges of an increasingly common infection seen in non-endemic countries, and highlights both daily management dilemmas and associated difficulties that arise.
authors.affiliation: National Referral Centre for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, Insituto Ramón y Cajal de Investgación Sanitaria, Madrid, Spain. Electronic address: jperezm@salud.madrid.org.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Pérez-Molina
authors.affiliation: National Referral Centre for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, Insituto Ramón y Cajal de Investgación Sanitaria, Madrid, Spain.
authors.forename: Angela Martinez
authors.initials: AM
authors.lastname: Perez
authors.affiliation: National Referral Centre for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, Insituto Ramón y Cajal de Investgación Sanitaria, Madrid, Spain.
authors.forename: Francesca F
authors.initials: FF
authors.lastname: Norman
authors.affiliation: National Referral Centre for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, Insituto Ramón y Cajal de Investgación Sanitaria, Madrid, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Monge-Maillo
authors.affiliation: National Referral Centre for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal Hospital, Insituto Ramón y Cajal de Investgación Sanitaria, Madrid, Spain.
authors.forename: Rogelio
authors.initials: R
authors.lastname: López-Vélez
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D014355:Chagas Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D016054:DNA, Protozoan / Q000235:genetics / Q000302:isolation & purification; D054242:Emigrants and Immigrants; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D058069:Neglected Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D016133:Polymerase Chain Reaction; D013030:Spain; D014349:Trypanosoma cruzi / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*
chemical_list: D000913:Antibodies, Protozoan; D016054:DNA, Protozoan