ABSTRACT
Travelers to Chagas disease endemic regions of Latin America may be at risk for Trypanosoma cruzi infection. We report a 67-year-old woman who screened positive for T. cruzi infection while donating blood. The patient had a history of an unusual febrile illness and marked swelling of the face sustained at age 10 after camping in northern Mexico that led to a 3-week hospitalization without a diagnosis. More than 4 decades later, rapid diagnostic tests and commercial and confirmatory serology for Chagas disease were all positive for T. cruzi infection. On evaluation, the patient described a progressive chronic cough, gastroesophageal reflux, and dysphagia for > 10 years. There was no evidence of any cardiac complications. However, esophageal manometry demonstrated significant dysmotility, with 90% of swallows being ineffective with evidence of esophageal pressurization and retrograde peristalsis in several swallows, suggesting early autonomic disruption due to Chagas disease esophagopathy. In this report, we highlight the importance of travel-related Chagas disease among travelers to endemic regions and the need to further identify potential risks of transmission among this at-risk population.
Subject(s)
Chagas Disease , Trypanosoma cruzi , Female , Humans , Child , Aged , Travel , Travel-Related Illness , Mexico/epidemiologyABSTRACT
Subarachnoid involvement is a rare but severe form of neurocysticercosis (NCC), leading to serious complications if not recognized and treated appropriately. Imaging of the brain usually involves computed tomography and/or magnetic resonance image (MRI) of the brain, both of which can lead to a diagnosis of NCC. We present a 20-year-old female with no significant past medical history presenting with a new-onset seizure whose clinical treatment was significantly altered when subarachnoid involvement was identified. This case highlights the importance of brain MRI in recognizing subarachnoid disease, an important subset of NCC disease presentation.