Nervous System- Infection & Inflammation I
Question No. 10. The Answer is: (B) 1 and 3 are true.
1. Also known as American trypanosomiasis.
3. An acute or chronic infection caused by Trypanosoma cruzi that is transmitted by reduviid bugs of the genus Triatom.
Discussion: Charga's disease is caused by Trypanosoma cruzi that is transmitted by reduviid bugs of the genus Triatom and is also know as American trypanosomiasis. It is seen predominantly in rural areas in Central and South America as well as in Java and India. There is an initial phase which is usually transient and subclinical. Acute infection is most common in children. Acute encephalitis due to Trypanosoma cruzi is uncommon. About 10-30% who developed the acute infection will evolve into the chronic phase which has only rare symptomatic manifestations of the central nervous system (CNS). Trypanosoma cruzi has a great tendency to involve the skeletal muscle and cardiac muscle. One of the major clinical manifestations are Chagasic cardiomyopathy that would cause congestive heart failure, arrythmias, and/or thromboemboli. The other major manifestation is megaesophagus or megacolon (“megadisease”).
In contrast, African trypanosomiasis (or sleeping sickness) is caused by Trypanosoma brucei rodesiense (in East and Central Africa) and Trypanosoma brucei gambiense (in West Africa). Meningoencephalitis is typically seen at the later stage of the disease. Neuropathologic findings include adhesion of the dura and leptomeninges at the vertex of the brain and associated with a sticky, milky exudate. Histologically, there is intense perivascular lymphocytic-plasmacytic infiltration. The parasites were usually not seen. Severe hemorrhagic leukoencephalopathy can also occur.
[Click here to see a case of Aftican trypanosomiasis] [Click here to see a case of Chaga's disease]