A Case of Chagas Cardiomyopathy Following Infection in South Central Texas

Abstract : Chagas disease has been identified by the World Health Organization as one of the most marginalized tropical zoonotic diseases despite affecting 8 million people worldwide. The Trypanosoma cruzi parasite and several genera and species of triatomine insect vectors (also called kissing bugs) have been well established to be the infectious origins for human Chagas disease throughout the New World Tropics and parts of the southern United States. To date, the vast majority of documented U.S. infections have been in Latin American immigrants who were infected in their home countries and it has been estimated that 300,000 infected immigrants presently reside in the United States. At present, there have been less than 30 autochthonous cases reported in the United States although since it was made reportable in Texas in 2013, the case count continues to climb and this low number is likely attributable to under recognition and reporting. We present a well-documented autochthonous case of Chagasic cardiomyopathy in an 18 year-old U.S. Air Force trainee, native Texan, who had positive screening for T.cruzi without any history of travel outside of the United States. We offer review of our extensive cardiovascular evaluation that was completed in order to diagnose, offer treatment options, and execute military relevant implications with effort to increase awareness o f this under recognized and under reported condition .