RESUMEN
We report a fatal case of vector-transmitted acute Chagas' myocarditis in a seven-month-old child in south Texas. This diagnosis was not suspected during the three days of hospitalization that preceded the child's death, which was caused by heart failure. A diagnosis of acute myocarditis, probably of viral origin, was listed as the cause of death after cardiac tissue was examined microscopically at autopsy. One year after the death of the patient, a diagnosis of Trypanosoma cruzi myocarditis, based solely on morphological grounds, was made after newly prepared slides of cardiac tissue were examined. Seven years later, we confirmed the diagnosis of T. cruzi infection by using the polymerase chain reaction to amplify a species-specific genomic repetitive DNA sequence of the parasite from fixed cardiac tissue.
Asunto(s)
Cardiomiopatía Chagásica/diagnóstico , Trypanosoma cruzi , Enfermedad Aguda , Animales , Secuencia de Bases , Cardiomiopatía Chagásica/parasitología , ADN Protozoario/genética , Resultado Fatal , Humanos , Lactante , Masculino , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADN , Trypanosoma cruzi/genéticaRESUMEN
Concentrations of zinc and inorganic phosphorus were determined in amniotic fluid from 41 patients with intra-amniotic infection and from 40 uninfected, control patients. Also determined was amniotic fluid inhibitory activity to an Escherichia coli test organism. Compared to amniotic fluid from control patients, that from patients with intra-amniotic infection had significantly higher mean concentrations of phosphorus. In specimens free of meconium, the mean concentrations of phosphorus were still significantly higher. Assays for inhibitory activity were performed with 62 samples of fluid (25 noninhibitory, 37 inhibitory). Although noninhibitory fluid had higher mean concentrations of phosphorus and zinc, these differences did not hold after meconium-stained samples were excluded. No correlation was found between phosphorus-to-zinc ratio and either intra-amniotic infection or inhibitory activity. However, there are important differences in population and techniques between this and related studies.