An unusual case of congestive heart failure in the Netherlands.
| Autor: | Persoon MC; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands., Manintveld OC; Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands., Mollema FPN; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands.; Present address: Department of Internal Medicine, Haaglanden Medisch Centrum, The Hague, The Netherlands., van Hellemond JJ; Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | JMM case reports [JMM Case Rep] 2018 Mar 06; Vol. 5 (4), pp. e005142. Date of Electronic Publication: 2018 Mar 06 (Print Publication: 2018). |
| DOI: | 10.1099/jmmcr.0.005142 |
| Abstrakt: | Introduction: Chagas disease is caused by infection with the protozoan Trypanosoma cruzi. It is endemic to the American continent due to the distribution of its insect vectors. The disease is occasionally imported to other continents by travel of infected individuals. It is rarely diagnosed in the Netherlands and exact numbers of infected individuals are unknown. Clinical manifestations can start with an acute phase of 4-8 weeks with non-specific, mild symptoms and febrile illness. In the chronic phase, it can lead to fatal cardiac and gastro-intestinal complications. Case Presentation: We describe a case of a 40-year-old man with end-stage cardiomyopathy due to Chagas disease. He lived in Surinam for more than 20 years and had an unremarkable medical history until he was hospitalized due to pneumonia and congestive heart failure. Despite antibiotic treatment and optimizing cardiac medication, his disease progressed to end-stage heart failure for which cardiac transplantation was the only remaining treatment. A left ventricular assist device (LVAD) was implanted as a bridge to transplantation. Tissue analysis after LVAD surgery revealed ongoing myocarditis caused by Chagas disease. Based on a literature review, a scheme for follow up and treatment after transplantation was postulated. Conclusion: Chagas disease should be taken into account in patients from endemic countries who have corresponding clinical signs. Heart transplantation in patients with Chagas cardiomyopathy is accompanied by specific challenges due to the required immunosuppressive therapy and the thereby increased risk of reactivation of a latent T. cruzi infection. Competing Interests: The authors declare that there are no conflicts of interest. |
| Databáze: | MEDLINE |
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