Summary
Definition
ანამნეზი და გასინჯვა
ძირითადი დიაგნოსტიკური ფაქტორები
- prolonged fever
- palpitations
- syncope or presyncope
- hepatosplenomegaly
- enlarged lymph nodes
- tachycardia
- hypotension
- cardiomegaly
- dysphagia
- regurgitation/aspiration
- odynophagia
- substernal discomfort
- prolonged constipation
- acute abdominal pain
- abdominal distention
- swelling around the site of inoculation
- jaundice
- abdominal rebound tenderness
- clinical evidence of meningeal irritation
- clinical signs of a cerebral mass lesion
სხვა დიაგნოსტიკური ფაქტორები
- irritability
- anorexia or fatigue
- vomiting or diarrhea
- headache
- myalgia
- reduced exercise tolerance
- dizziness
- thromboembolic phenomena (e.g., stroke, pulmonary embolism)
- dyspnea
- cough
- generalized edema
- pericarditis
- epigastric pain and/or hematemesis
- melena or hematochezia
- rash
- seizures or tremors
რისკფაქტორები
- living in endemic area
- exposure to Triatoma species
- low socioeconomic status
- consumption of contaminated food or drink
- blood transfusion
- organ transplantation
- history of immunosuppression
- climate change
- deforestation
- laboratory work occupations
- travel to endemic areas
- mother with Chagas disease
დიაგნოსტიკური კვლევები
1-ად შესაკვეთი გამოკვლევები
- CBC
- LFTs
- serum electrolytes, BUN, and creatinine
- microscopy: fresh blood
- microscopy: concentration methods applied to fresh blood
- microscopy: thick blood smear
- enzyme-linked immunosorbent assay based on parasite lysate
- immunofluorescent antibody test
- indirect hemagglutination antibody test
- chemiluminescence
- radio-immunoprecipitation assay
- western blot
- polymerase chain reaction (PCR)
- urinalysis
- serum or urine beta-hCG
- ECG with a 30-second lead II rhythm strip
- chest x-ray
- barium swallow
- barium enema
გასათვალისწინებელი კვლევები
- culture (blood and cerebrospinal fluid)
- xenodiagnosis
- cerebrospinal fluid analysis
- coagulation profile
- ambulatory 24-hour ECG
- exercise testing
- echocardiography
- esophageal manometry
- upper gastrointestinal endoscopy
- cranial CT/MRI
- cardiac MRI
- nuclear medicine testing
- cardiac catheterization and coronary angiography
ახალი ტესტები
- immunochromatography
- commercial polymerase chain reaction (PCR) kits
მკურნალობის ალგორითმი
accidental exposure and infection: nonpregnant without severe renal/hepatic insufficiency
accidental exposure and infection: pregnant or with severe renal/hepatic disease
acute infection
reactivated disease
chronic infection: indeterminate disease or mild to moderate symptoms: children
chronic infection: indeterminate disease or mild to moderate symptoms: adults
chronic infection: advanced disease: children and adults
end-stage organ failure
კონტრიბუტორები
ავტორები
Alejandro Marcel Hasslocher-Moreno, MD, MBA, MSc, PhD
Infectious Diseases Physician
Evandro Chagas National Institute of Infectious Diseases
Oswaldo Cruz Foundation (Fiocruz)
Rio de Janeiro
Brazil
გაფრთხილება:
AMHM was reimbursed by Faculdade Unyleya in Rio de Janeiro, Brazil, for coordinating a course on Tropical Medicine. He is also the author of several articles cited in this topic.
მადლიერება
Dr Alejandro Marcel Hasslocher-Moreno would like to gratefully acknowledge Dr Alberto Novaes Ramos Jr, Dr Jorg Heukelbach, Dr Andrea Silvestre de Sousa, and Dr Francisco Rogerlândio Martins-Melo, all previous contributors to this topic.
გაფრთხილება:
ANR Jr is an author of a number of references cited in this topic. JH, ASS, and FRMM declare that they have no competing interests.
რეცენზენტები
Christopher Huston, MD
Assistant Professor of Medicine
Division of Infectious Diseases
University of Vermont College of Medicine
Burlington
VT
გაფრთხილება:
CH declares that he has no competing interests.
Richard Reithinger, MD, PhD
Professor
London School of Hygiene and Tropical Medicine
London
UK
გაფრთხილება:
RR declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
წყაროები
ძირითადი სტატიები
Nunes MCP, Beaton A, Acquatella H, et al. Chagas cardiomyopathy: an update of current clinical knowledge and management: a scientific statement from the American Heart Association. Circulation. 2018 Sep 18;138(12):e169-209.სრული ტექსტი აბსტრაქტი
Dias JC, Ramos AN Jr, Gontijo ED, et al. 2 nd Brazilian Consensus on Chagas disease, 2015. Rev Soc Bras Med Trop. 2016 Dec;49Suppl 1(Suppl 1):3-60.სრული ტექსტი აბსტრაქტი
Bern C, Montgomery SP, Herwaldt BL, et al. Evaluation and treatment of Chagas disease in the United States: a systematic review. JAMA. 2007 Nov 14;298(18):2171-81.სრული ტექსტი აბსტრაქტი
Meymandi S, Hernandez S, Park S, et al. Treatment of Chagas disease in the United States. Curr Treat Options Infect Dis. 2018 Jun 26;10(3):373-88.სრული ტექსტი აბსტრაქტი
Pan American Health Organization. Guide to the diagnosis and treatment of chagas disease. Jun 2019 [internet publication].სრული ტექსტი
World Health Organization. Chagas disease (American trypanosomiasis): treatment. 2018 [internet publication].სრული ტექსტი
გამოყენებული სტატიები
ამ თემაში მოხსენიებული წყაროების სრული სია ხელმისაწვდომია მომხმარებლებისთვის, რომლებსაც აქვთ წვდომა BMJ Best Practice-ის ყველა ნაწილზე.
დიფერენციული დიაგნოზები
- CNS toxoplasmosis
- Non-Chagas-related cardiomyopathy
- Toxic megacolon
მეტი დიფერენციული დიაგნოზებიგაიდლაინები
- CDC Yellow Book: health information for international travel - American trypanosomiasis (Chagas disease)
- Prevention and treatment of opportunistic infections in adults and adolescents with HIV: Chagas disease
მეტი გაიდლაინებიშედით სისტემაში ან გამოიწერეთ BMJ Best Practice
ამ მასალის გამოყენება ექვემდებარება ჩვენს განცხადებას