Chagas disease: An increasing clinical concern

Chagas disease (CD), or American trypanosomiasis, is a parasitic infection caused by Trypanosoma cruzi and transmitted primarily by triatomine "kissing bugs." Once limited to Latin America, CD is now considered endemic in the United States (US), affecting an estimated 280 000 individuals. This article aims to highlight the growing clinical relevance of CD through a case example and review of its epidemiology, clinical features, and management. Globally, 6 to 8 million people are infected, resulting in more than 50 000 deaths annually. Globalization, migration, and climate change have expanded its geographic reach, with increasing detection of infected insect populations in the southern US. CD progresses through acute and chronic phases. The acute phase is often mild or asymptomatic, whereas 30% to 40% of untreated patients progress to chronic disease, most commonly manifesting as cardiomyopathy. Diagnosis is made by serologic or molecular testing, and treatment with benznidazole or nifurtimox is most effective during the early stages of infection. Chronic disease remains incurable, underscoring the importance of early detection and prevention. Containment relies on vector control, screening of blood products and at-risk populations, and prenatal testing. A case of a recently immigrated patient diagnosed at a US urgent care clinic illustrates the need for clinical awareness of this neglected disease. Broader surveillance, education, and integrated public health strategies are essential to reduce CD-related morbidity and mortality.