Miocarditis chagásica aguda mortal

Abstract

1) A fatal case is reported of acute Chagas miocarditis a 17-year-old male, a resident of a suburb of San José CR. 2) The etiological diagnosis was not made i n the clinic, nor at the macroscopic autopsy. 3) The principal clinical facts were: an indefinite infectious state of a month's duration, which in the last week changed to a picture of violent cardiac insufficiency, with global cardiomegaly and gallop rhythm, without any sign of valvular disease. The hemogram showed lymphomonocytosis 40%. 4) The anatomopathologic findings included: signs of chronic pulmonary and abdominal visceral stasis; moderate cardiomegaly (360 gr.), parietal throm­bosis in the left ventricle, miocardial flaccidity with dilatation of all the cavities. Acute intense miocarditis; reticular hyperplasia in Peyer's patches, mesenteric ganglia and spleen. 5) Epidemiologic investigation showed 32 out of 116 dwellings of the neigh­borhood where the patient lived, to be infested by triatomids, 30% of which were infested with Trypanosoma cruzi. 6) Domestic carriers of T. cruzi so far reported from Costa Rica are and Rhodnius prolixus. Triatoma dimidiata 7) Up to April 1954, 20 cases have been reported from Costa Rica of Chagas disease, 3 of which have be en fatal.