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Advanced megaesophagus (Group III) secondary to vector-borne Chagas disease in a 20-month-old infant

Anis Rassi1, Joffre Marcondes de Rezende, Anis Rassi

  • 1Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, GO.

Revista Da Sociedade Brasileira De Medicina Tropical
|April 27, 2012
PubMed

Insights

Chagas disease in an infant caused megaesophagus and malnutrition, successfully treated with surgery and benznidazole. Long-term follow-up showed no disease recurrence and normal development, including a healthy pregnancy.

Area of Science:

  • Infectious Diseases
  • Pediatric Gastroenterology
  • Tropical Medicine

Background:

  • Chagas disease, caused by *Trypanosoma cruzi*, can lead to chronic complications like megaesophagus.
  • Megaesophagus in infants presents significant challenges, including severe malnutrition and feeding difficulties.

Observation:

  • A female infant presented with Group III megaesophagus attributed to congenital Chagas disease.
  • The infant experienced severe malnutrition, necessitating surgical intervention (Heller technique).

Findings:

  • Post-surgery, the patient received benznidazole, leading to parasitological and serological cure of Chagas disease.
  • Long-term follow-up over several years demonstrated sustained disease remission, normal physical development, and a healthy pregnancy at age 23.
  • Thirty years post-diagnosis, the patient maintained normal cardiac and pulmonary function, evidenced by normal electrocardiogram, echocardiogram, and chest radiography.

Implications:

  • This case highlights the successful management of pediatric megaesophagus secondary to Chagas disease.
  • It underscores the importance of early diagnosis and treatment of Chagas disease in preventing long-term morbidity.
  • The findings support the efficacy of combined surgical and antiparasitic treatment for severe congenital Chagas disease with esophageal involvement.

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