| leiomyosarcoma constitutes approximately 0.5% of the malignant neoplasias of the esophagus and its association with megaesophagus has not been described. We report on a case of a woman with dysphagia that was slowly progressive from the age of 19 due to chagasic megaesophagus. The woman was subjected to cardiomyotomy at the age of 49. She presented a rapid worsening of the dysphagia due to leiomyosarcoma at the age of 61, and was subjected to subtotal esophagectomy with cervical esophagogastroplasty. She developed pulmonary and hepatic metastases 14 months after surgery and died six months later. ( info) |
2/80. Massive tracheal necrosis due to compression by an innominate artery aneurysm associated with a grade IV Chagasic megaesophagus and chronic duodenal ulcer. A 49-year-old man suffered necrosis of the cephalad tracheal segment due to compression by an innominate artery aneurysm. A peritracheal abscess, a grade IV chagasic megaesophagus, and a duodenal ulcer were also present. The patient underwent a three-stage surgical treatment, and 7 years later he is doing well, and breathing and eating normally. ( info) |
| In July 1998, the mother of an 18-month-old boy in rural tennessee found a triatomine bug in his crib, which she saved because it resembled a bug shown on a television program about insects that prey on mammals. The gut contents of the triatoma sanguisuga were found, by light microscopy and polymerase chain reaction (PCR), to be infected with trypanosoma cruzi; PCR products hybridized with T. cruzi-specific oligonucleotide probes. Whole-blood specimens obtained from the child in July and August were negative by buffy-coat examination and hemoculture but positive by PCR and dna hybridization, suggesting that he had low-level parasitemia. Specimens obtained after treatment with benznidazole were negative. He did not develop anti-T. cruzi antibody; 19 relatives and neighbors also were seronegative. Two of 3 raccoons trapped in the vicinity had positive hemocultures for T. cruzi. The child's case of T. cruzi infection-the fifth reported US autochthonous case-would have been missed without his mother's attentiveness and the availability of sensitive molecular techniques. ( info) |
| A 27-year-old woman with the acquired immunodeficiency syndrome and endocervical Chagas' disease is reported. The patient was a cocaine addict, and her sexual partner was also human immunodeficiency virus (hiv)-positive. Her past medical history included a son who died 3 days after birth due to congenital Chagas' disease. Seven years later, through a cervical biopsy, a reactivation of Chagas' disease was diagnosed. giant cells with typical amastigotes were seen; they strongly stained with antibodies against trypanosoma cruzi. The patient died 5 months later of an acute chagasic myocardiopathy. To our knowledge, this is the first report of this parasitosis in the cervix uteri. ( info) |
5/80. Image analysis of nucleomegalic cells in Chagas' disease placentitis. Villous stroma nucleomegalic cells harbouring intracytoplasmic parasites are an unusual finding which appears to be restricted to Chagas' disease placentitis. Ploidy analysis of these cells in two cases (twelve nuclei in Case 1 and 26 in Case 2) showed these nuclei to contain quantitatively abnormal dna. Only a few were diploid, the rest proving to be tetraploid, hypertetraploid and even aneuploid. Little is known about the pathogenesis of these macronuclei. However, since these cells contain large numbers of parasites it is possible that a parasite-induced derangement of the cell cycle at g2 phase may be operative. ( info) |
6/80. Bilateral pulmonary artery aneurysm associated with bilateral pulmonary thromboembolism, superior vena caval thrombosis, and Chagas' disease--a case report. The authors report a case of bilateral pulmonary artery aneurysm in a patient with chronic Chagas' disease and compensated congestive heart failure in whom clinical clues suggested pulmonary thromboembolism, and the actual nature of the lesions was discovered at the time of conventional imaging investigations. This case shows the rarity of bilateral pulmonary aneurysm associated with bilateral pulmonary thromboembolism and the importance of an awareness of this condition in the differential diagnosis for lung masses. ( info) |
| OBJECTIVE: To determine the prevalence of trypanosoma cruzi infection among dogs in oklahoma. DESIGN: Cross-sectional study. animals: 301 owned or impounded dogs related by ownership or general geographic location to 3 dogs determined to have trypanosomiasis. PROCEDURES: blood samples were obtained from dogs between November 1996 and September 1997. infection status was determined by use of a radioimmunoprecipitation assay. Second blood samples were obtained from some of the seropositive dogs for study by hemoculture and polymerase chain reaction (PCR) assay. Sites where infected dogs were found were inspected for triatomine insects, and light traps were used for vector trapping. RESULTS: 11(3.6%) dogs were seropositive for T. cruzi infection. Ten of the 11 were owned rural hunting dogs. Protozoal organisms isolated from the blood of 1 seropositive dog were identified as T. cruzi by PCR testing. Only 1 adult triatoma sanguisuga was captured in a light trap at a site near infected dogs; this insect was not infected. CONCLUSIONS AND CLINICAL RELEVANCE: Our findings suggest that T. cruzi is enzootic in eastern oklahoma. Measures that would reduce the risk of dogs acquiring T. cruzi infection are unlikely to be acceptable to their owners, and no effective drugs are available for treatment. The presence of T. cruzi-infected dogs poses a threat of transmission to persons at risk of exposure to contaminated blood veterinarians who practice in the southern united states should be cognizant of this blood borne zoonosis and educate all personnel about appropriate precautions. ( info) |
8/80. Reactivation of chronic Chagas' disease following allogeneic bone marrow transplantation and successful pre-emptive therapy with benznidazole. This report shows the early detection of reactivation of chronic Chagas' disease (CCd) in a 27-year-old man with chronic myelogenous leukemia undergoing allogeneic bone marrow transplantation (ABMT). Pre-emptive therapy with benznidazole during a period of 7 weeks led to a rapid recovery of the patient, who remains free of parasitemia 2 years after the bone marrow transplantation. ( info) |
9/80. Chagasic megaesophagus and megacolon diagnosed in childhood and probably caused by vertical transmission. Reports on children presenting symptoms compatible with the chronic phase of chagas disease are sporadic. We report a case of a 7-year-old boy who had megaesophagus and megacolon, both of them a consequence of the trypanosomiasis. The etiology was established by means of laboratory and histological features. Based on epidemiological data, the authors concluded that vertical transmission was the most probable route of acquisition. This diagnosis should be considered in children presenting similar complaints, even those living away from endemic areas. ( info) |
10/80. Congenital chagas disease of second generation in Santiago, chile. Report of two cases. Congenital chagas disease (CChD) has been reported in different countries, mostly in latin america. In 1987 a fatal case of CChD of second generation (CChDSG) was published. Within a period of six months--1989-1990--two cases of CChDSG were diagnosed and studied in the city of Santiago. Two premature newborns, sons of two sisters, with moderate liver and spleen enlargement, were found to have positive serology for chagas disease and xenodiagnoses. The mothers, urban residents all their lives, without antecedents of triatomine bugs contact or blood transfusions, showed positive serology and xenodiagnoses. Their mother (grandmother of the infants), lived 20 years in a Northern rural chagas disease endemic locality, in a triatomine infested house. Afterwards, she moved to Santiago, where she married and has resided up to now. serology and xenodiagnoses were also positive. All the trypanosoma cruzi infected individuals were successfully treated with nifurtimox. ( info) |