Editor's Abstract:
In 2010, the 63rd World Health Assembly passed resolution WHA63.20, highlighting the seriousness of Chagas disease in both endemic and non-endemic countries, which called for measures to address Chagas disease transmission, diagnostics, and treatment at all levels. The increasing presence of Chagas in non-endemic areas (mostly due to immigration, blood transfusion, and organ transplantation), as well as the resurgence of the disease in endemic countries, has been a major focus of attention in recent years.
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.
For more information see: http://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(15)00243-1.pdf
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