Acute Chagas Cardiomyopathy: Case Report and Literature Review

Abstract

Chagas myocarditis is a complication of the acute phase of Chagas' disease, a zoonosis produced by a intracellular protozoan called Trypanosoma cruzi, endemic of Central and South America and generally transmitted to humans through a triatomine vector. Acute Myocarditis may cause death, with a mortality ranging from 0.01 to 1%, generally associated with fatal dysrhythmias. The international publications of cases with acute myocarditis by Chagas diagnosed at autopsies are scarce and in infants are limited to a few reports. In the national journals we did not find any published case of acute chagasic myocarditis diagnosed post-mortem in pediatric patients, for that reason we considered important to report this case. We present the case of a 10-month-old male infant, with history of difficulty breathing and peribucal cyanosis; he was received in poor general condition and bradycardic (HR: 30 x min), deteriorating rapidly and dying 55 minutes after admission. A legal medical autopsy was performed, the relevant findings being in the heart: severe diffuse lymphoplasmocytic inflammatory infiltrate and myocardial fibers with degeneration, some of them containing amastigotes of Trypanosoma cruzi. According to the histological findings, the diagnosis and cause of death was Acute Chagasic Myocarditis. We conclude that in this case the severity of the cardiac lesion produced by the parasite led to a fatal outcome, we recomended that public health strategies should be implemented to prevent the transmission of this disease.