RESUMO
We describe the eleventh major outbreak of foodborne Trypanosoma cruzi transmission in urban Venezuela, including evidence for vertical transmission from the index case to her fetus. After confirming fetal death at 24 weeks of gestation, pregnancy interruption was performed. On direct examination of the amniotic fluid, trypomastigotes were detected. T. cruzi specific-polymerase chain reaction (PCR) also proved positive when examining autopsied fetal organs. Finally, microscopic fetal heart examination revealed amastigote nests. Acute orally transmitted Chagas disease can be life threatening or even fatal for pregnant women and unborn fetuses owing to vertical transmission. There is therefore an urgent need to improve national epidemiologic control measures.
Assuntos
Doença de Chagas/transmissão , Morte Fetal/etiologia , Parasitologia de Alimentos , Doenças Transmitidas por Alimentos/parasitologia , Transmissão Vertical de Doenças Infecciosas , Adolescente , Adulto , Doença de Chagas/complicações , Doença de Chagas/epidemiologia , Surtos de Doenças , Feminino , Humanos , Hidropisia Fetal/parasitologia , Reação em Cadeia da Polimerase , Gravidez , População Urbana , Venezuela/epidemiologia , Adulto JovemRESUMO
We describe the eleventh major outbreak of foodborne Trypanosoma cruzi transmission in urban Venezuela, including evidence for vertical transmission from the index case to her fetus. After confirming fetal death at 24 weeks of gestation, pregnancy interruption was performed. On direct examination of the amniotic fluid, trypomastigotes were detected. T. cruzi specific-polymerase chain reaction (PCR) also proved positive when examining autopsied fetal organs. Finally, microscopic fetal heart examination revealed amastigote nests. Acute orally transmitted Chagas disease can be life threatening or even fatal for pregnant women and unborn fetuses owing to vertical transmission. There is therefore an urgent need to improve national epidemiologic control measures.
Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Adulto Jovem , Parasitologia de Alimentos , Doença de Chagas/transmissão , Transmissão Vertical de Doenças Infecciosas , Morte Fetal/etiologia , Doenças Transmitidas por Alimentos/parasitologia , População Urbana , Venezuela/epidemiologia , Hidropisia Fetal/parasitologia , Reação em Cadeia da Polimerase , Surtos de Doenças , Doença de Chagas/complicações , Doença de Chagas/epidemiologiaRESUMO
The prenatal diagnosis of congenital transmission of Chagas' disease in a pregnant woman with the indeterminate form of the disease is reported. Sonography revealed fetal hydrops at 31 weeks' gestation. Anti-Trypanosoma cruzi IgM and IgG antibodies were negative in the fetal blood sampled by cordocentesis, but T. cruzi trypomastigotes were found in its buffy coat. Owing to anemia, in utero exchange transfusion was undertaken, but fetal demise ensued. Labor was induced and a stillborn infant weighing 2030 g was delivered. The pathological examination revealed placentitis and meningoencephalitis, myocarditis and splenitis in the stillborn fetus. Amastigotes were found in the myocardium, brain and placenta.
