Fig.60-A1
Chagas Disease

A 9-year old boy from a village south of the town Barinas / Venezuela is suffering fever since 10 days, feels weak and has arthralgias. Above the upper parts of his nose a reddish, painful region of the skin had developed with a diameter of 2,5 cm. The fact, that the boy came from an endemic region of the Chagas disease was the reason to make a special examination of his blood which confirmed the presence of parasites of the protozoan species Trypanosoma cruzi. Therefore a so called chagoma was assumed to be present produced by the sting of a vector. Another consequence of a primary infection of this kind is the Romaña sign which we will describe in the next case.

Fig.60-A2
Chagas Disease

In the blood smears coloured by the Giemsa stain und under high power a flagellate protozoon, Trypanosoma cruzi, could be demonstrated. At his front end the nucleus and on his posterior parts an elongated cariosoma are seen. From the latter the flagellum is starting.

Fig.60-A3
Chagas Disease

The Chagas-infection produces frecuently a myocarditis, here also with a gigant cell. Parasites are not present in this field.

Fig.60-A4
Chagas Disease

Occasionally an elongated kinetoplasst can be recognized in an amastigote of an nest in a myocardial fiber.

Fig.60-A5
Chagas Disease

In addition to the infestation of the myocard a chagasic encephalitis is relatively frequent. Here a nest of amastigotes of Trypanosoma cruzi is demonstrated in the brain. The other organs are infested more seldom.

Fig.60-A6
Chagas Disease

In cases of chronic Chagas myocarditis, as in this case, giant cells can be seen, but mostly no parasites.