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[Akinetic pseudomutism (locked-in syndrome) in accidental Chagas' disease]
Insights
Chagas' disease, caused by Trypanosoma cruzi, can be transmitted via blood transfusions, leading to severe neurological complications like "locked-in" syndrome. This highlights the need for better screening in endemic areas.
Area of Science:
- Infectious Diseases
- Neurology
- Cardiology
Background:
- Chagas' disease, caused by Trypanosoma cruzi, is prevalent in Central and South America.
- Myocardial involvement is a key feature of chronic Chagas' disease, leading to heart failure and arrhythmias.
- Traditional transmission is via insect vectors, but blood transfusions are an emerging concern.
Observation:
- A case study of a young architect who contracted Chagas' disease, likely through a blood transfusion.
- The patient subsequently developed "locked-in" syndrome, a severe neurological condition.
- Computed tomography revealed lesions in the pons, indicative of neurological involvement.
Findings:
- Blood transfusions represent a significant, often overlooked, transmission route for Trypanosoma cruzi.
- Chagas' disease can manifest with severe neurological complications, including "locked-in" syndrome.
- Electrocardiographic abnormalities are common, affecting 87% of patients with chronic Chagas' disease.
Implications:
- Emphasizes the critical need for rigorous blood transfusion screening in Chagas' disease endemic regions.
- Highlights the importance of considering Chagas' disease in differential diagnoses, even in non-endemic areas.
- Underscores the utility of computed tomography in diagnosing Trypanosoma cruzi-related neurological lesions.
Abstract:
Chagas' disease is a major problem in Central and South America. The disease is caused by Trypanosoma cruzi, a protozoon which may inhabit the blood and tissues of both man and animals. Although it may produce marked enlargement of several hollow viscera, myocardial involvement is the hallmark of chronic Chagas' disease. The clinical picture of chronic Chagas myocardites is one of insidious, progressive, prolonged congestive heart failure and cardiac enlargement. The almost invariable arrhythmias make syncope and sudden death common in patients both with p6 without congestive heart failure. Electrocardiographic abnormalities occur in 87 percent of patients with chronic Chagas' disease and are often the initial manifestation of illness . Pathological findings include mural trombosis which often results in pulmonary and central nervous system embolization. Trypanosoma cruzi is in general transmitted to human beings by the bite of haematophagus insects of the reduviidae family, but in the last years reports pointing out the importance of blood transfusions as infectious sources of Trypanosoma cruzi are becoming more and more frequent. The authors present a case of a male young architect which contrated Chagas' disease probably by a blood transfusion and latter developed "locked-in" syndrome. It is discussed the importance of blood transfusion as a source of transmission of the disease even in non-endemic areas and the need to controlling all blood transfusions in countries where Chagas' disease is endemic. The authors also point out the importance of computed tomography in the diagnosis of lesions in the pons.