2020, Number 04
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Ginecol Obstet Mex 2020; 88 (04)
Chagas disease vertical transmission: Case report
Sandoval-Martínez DK, Jaimes-Sanabria MZ, Jiménez-Vargas FL
Language: Spanish
References: 18
Page: 271-276
PDF size: 266.68 Kb.
ABSTRACT
Background: Chagas disease is a zoonosis caused by
Trypanosoma cruzi, a parasite
endemic to Latin America. Children become infected by contact with vectors or by
congenital transmission.
Clinical cases: Illiterate indigenous patient, 32 years old, from the rural area of western
Colombia, with a history of 7 pregnancies and 6 deliveries, the current pregnancy with
29.5 weeks determined by the third trimester ultrasound, without prenatal controls, with
preterm labor and severe oligohydramnios. The pregnancy ended by cesarean section,
without complications and the birth of a girl who weighed 1290 g. At 50 days of life,
he developed hemodynamic instability, respiratory distress, mucocutaneous pallor and
fever with a diagnosis of sepsis of undetermined origin. Extension studies reported:
positive microhematocrit parasitaemia for
Trypanosoma cruzi, with amastigotes in the
cerebrospinal fluid. Diagnosis: Chagasic meningoencephalitis.
Conclusions: The vertical transmission of Chagas disease is low; congenital
transmission is responsible for the progressive appearance of the disease in endemic
and non-endemic areas. In pregnant women, it is important to include screening for
Trypanosoma cruzi infection, as part of the prenatal control test suite.
REFERENCES
Pan American Health Organization. https://www.paho. org/hq/index.php?option=com_content&view=article& id=5856:2011-informacion-general-enfermedad-chagas &Itemid=40370&lang=en.
Bern C. Chagas’ Disease. N Engl J Med 2015; 373 (5): 456- 66. doi: 10.1056/NEJMra1410150.
Pan American Health Organization. https://www.who.int/ chagas/epidemiology/en/.
Castillo C, et al. Host-parasite interaction: changes in human placental gene expression induced by Trypanosoma cruzi. Parasit Vectors 2018; 11: 479. https://doi. org/10.1186/s13071-018-2988-0.
Organización Panamericana de la Salud. Nuevas generaciones sin la infección por el VIH, la sífilis, la hepatitis B y la enfermedad de Chagas en las Américas 2018. ETMI Plus. Washington, DC: OPS, 2019.
Coura JR. The main sceneries of Chagas disease transmission. The vectors, blood and oral transmissions -a comprehensive review. Mem Inst Oswaldo Cruz 2015; 110 (3): 277-82. https://doi.org/10.1590/0074- 0276140362.
Heller DS, et al. Travel History Is Important ! A Case of Trypanosoma cruzi Identified by Placental Examination. Pediatr Dev Pathol 2019; 22 (2): 175-76. https://doi. org/10.1177/1093526618789298.
Medina L, et al. Differential infectivity of two Trypanosoma cruzi strains in placental cells and tissue. Acta Trop 2018; 186: 35-40. https://doi.org/10.1016/j.actatropica. 2018.07.001.
Carlier Y, et al. Congenital Chagas disease as an ecological model of interactions between Trypanosoma cruzi parasites, pregnant women, placenta and fetuses. Acta Trop 2015; 151: 103-15. https://doi.org/10.1016/j.actatropica. 2015.07.016
Sarasúa W, et al. Chagas congénito. Placenta chagásica. Rev Med Urug 1986; 2: 149-154.
Cucunubá ZM, et al. Primer consenso colombiano sobre Chagas congénito y orientación clínica a mujeres en edad fértil con diagnóstico de Chagas. Infectio 2014; 18 (2): 50- 65. https://doi.org/10.1016/j.infect.2013.12.001.
Dias JC, et al. Brazilian Consensus on Chagas Disease, 2015. Epidemiol Serv Saude 2016; 25 (spe): 7-86. doi: 10.5123/ S1679-49742016000500002.
Kemmerling U, et al. Infection and invasion mechanisms of Trypanosoma cruzi in the congenital transmission of Chagas’ disease: A proposal. Biol Res 2010; 43 (3): 307-16. doi: /S0716-97602010000300007.
Díaz-Luján C, et al. Role of placental barrier integrity in infection by Trypanosoma cruzi. Acta Trop 2016; 164: 360- 68. https://doi.org/10.1016/j.actatropica.2016.09.021.
Rassi A Jr, et al. American Trypanosomiasis (Chagas Disease). Infect Dis Clin North Am 2012; 26 (2): 275-91. doi: 10.1016/j.idc.2012.03.002.
Baergen RN. Manual of Pathology of the Human Placenta. Second Edition. New York: Springer-Verlag, 2011; 110. doi:10.1007/978-1-4419-7494-5.
Apt W, et al. Congenital infection by Trypanosoma cruzi in an endemic area of Chile: A multidisciplinary study. Tras R Soc Trop Med Hyg 2013; 107 (2): 98-104. doi: 10.1093/ trstmh/trs013.
Francisco-González L, et al. Congenital transmission of Chagas disease in a non-endemic area, is an early diagnosis possible? PLoS ONE.2019; 14 (7): e0218491. doi: 10.1371/ journal. pone.0218491.