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ページの作成:「{{Floating_Menu}} *Named after Dr. Carlos Chagas, a Brazilian doctor who first described the disease in 1909 ==Pathogen== *''Trypanosoma cruzi'' ===Morphology=== #amas…」
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*Named after Dr. Carlos Chagas, a Brazilian doctor who first described the disease in 1909
==Pathogen==
*''Trypanosoma cruzi''
===Morphology===
#amastigote
#promastigote
#epimastigote
#trypomastigote
::nucleus, kintoplast, undulating membrane, flagellum
===Life cycle===
*''T. brucei'' group don't infect human cells
*''T. cruzi'' needs to infect human cells to multiply
**Armadillo is natural reservoir
==Transmission==
===by ''Triatomine''===
*Transmitted by oral ingestion or mucosal infestation of feces of ''Triatomine'', so-called 'kissing bugs'
*''Triatomine''
**Inhabits gaps on mud-built walls
**Sucks human blood but no blood transmission occurs
**Active during night
===by Mother-to-child===
==Epidemiology==
*In 21 Latin American countries
*700,000 new cases in 1990
*38,000 new cases in 2010
*Estimated 10,000 deaths/year by Chagas disease
==Clinical course==
*Acute phase
**Mainly asymptomatic
**local swelling at the site of inoculation (Chagoma)
***Romaña sign
**fever, anorexia, lymphadenopathy, mild hepatosplenomegaly, myocarditis
**trypomastigote found in blood for 8-12 weeks after infection
**children <5y/o fatal 10% in acute phase
*Chronic phase
**20-30% of infection
**10-40 years after infection
**cardiomegaly, arrhythmia, heart failure
***trypomastigotes invade and destruct cardiac muscle cells
***EKG shows typically right bundle branch block
**dilation of esophagus, megacolon - dysphagia and constipation
***trypomastigotes invade and destruct intestinal smooth muscle cells
==Diagnosis==
*blood smear, with blood centrifugation
*molecular
*serology
**ELISA, IFA, IHA
*clinical diagnosis
==Treatment===
*acute phase
**nifurtimox
**benznidazole (nitroimidazole)
**both contraindicated for pregnant women, kidney failure, liver failure
*chronic phase
**no specific treatment targeted pathogens
**supportive therapy for each organ dysfunction
==prevention and control==
*vector control
**improvement of house constructions
**insecticide
*mass screening
*Named after Dr. Carlos Chagas, a Brazilian doctor who first described the disease in 1909
==Pathogen==
*''Trypanosoma cruzi''
===Morphology===
#amastigote
#promastigote
#epimastigote
#trypomastigote
::nucleus, kintoplast, undulating membrane, flagellum
===Life cycle===
*''T. brucei'' group don't infect human cells
*''T. cruzi'' needs to infect human cells to multiply
**Armadillo is natural reservoir
==Transmission==
===by ''Triatomine''===
*Transmitted by oral ingestion or mucosal infestation of feces of ''Triatomine'', so-called 'kissing bugs'
*''Triatomine''
**Inhabits gaps on mud-built walls
**Sucks human blood but no blood transmission occurs
**Active during night
===by Mother-to-child===
==Epidemiology==
*In 21 Latin American countries
*700,000 new cases in 1990
*38,000 new cases in 2010
*Estimated 10,000 deaths/year by Chagas disease
==Clinical course==
*Acute phase
**Mainly asymptomatic
**local swelling at the site of inoculation (Chagoma)
***Romaña sign
**fever, anorexia, lymphadenopathy, mild hepatosplenomegaly, myocarditis
**trypomastigote found in blood for 8-12 weeks after infection
**children <5y/o fatal 10% in acute phase
*Chronic phase
**20-30% of infection
**10-40 years after infection
**cardiomegaly, arrhythmia, heart failure
***trypomastigotes invade and destruct cardiac muscle cells
***EKG shows typically right bundle branch block
**dilation of esophagus, megacolon - dysphagia and constipation
***trypomastigotes invade and destruct intestinal smooth muscle cells
==Diagnosis==
*blood smear, with blood centrifugation
*molecular
*serology
**ELISA, IFA, IHA
*clinical diagnosis
==Treatment===
*acute phase
**nifurtimox
**benznidazole (nitroimidazole)
**both contraindicated for pregnant women, kidney failure, liver failure
*chronic phase
**no specific treatment targeted pathogens
**supportive therapy for each organ dysfunction
==prevention and control==
*vector control
**improvement of house constructions
**insecticide
*mass screening
