Chagas disease is an infection caused by the parasite *Trypanosoma cruzi*, transmitted primarily through the bite of the triatomine bug, often called the “kissing bug.” The disease manifests in two main phases: acute and chronic, each with distinct signs and symptoms.
In the **acute phase**, which occurs shortly after infection and lasts about two months, symptoms may be mild or even absent, making early detection challenging. When symptoms do appear, they often resemble those of the flu or a general viral illness. Common signs include:
– **Fever** that persists over several days
– **Headache** and general malaise, a feeling of being unwell
– **Extreme fatigue** or tiredness that is disproportionate to activity levels
– **Swelling of the eyelids**, known as *Romaña’s sign*, which is a distinctive and significant puffiness around one eye indicating the parasite’s entry point
– **Chagoma**, a localized, painful red swelling or boil-like lesion at the site where the bug bit or the parasite entered the body
– **Swelling of the face and legs**
– **Enlarged lymph nodes**, which may be tender
– **Nausea, vomiting, and diarrhea**
– **Loss of appetite**
– **Body aches and muscle pain**
These symptoms typically appear within one to two weeks after infection but can vary depending on the mode of transmission. For example, when infection occurs through contaminated food, symptoms might appear within three to twenty-two days.
If untreated, the acute phase symptoms often subside, but the parasite remains in the body, progressing to the **chronic phase**. This phase can last for decades or even a lifetime, often without obvious symptoms for many years. However, over time, the parasite can cause serious damage to vital organs, leading to more severe signs:
– **Cardiac complications** such as an enlarged heart (cardiomegaly), heart failure, irregular heart rhythms, and even sudden cardiac arrest. This occurs because the parasite causes inflammation and scarring of the heart muscle.
– **Digestive system problems**, including enlargement of the esophagus (megaesophagus) or colon (megacolon), which can cause difficulty swallowing, severe constipation, or abdominal pain.
– **Enlargement of the liver and spleen** in some cases.
In some people, the chronic phase remains silent, with no symptoms for life, while in others, the progressive damage leads to debilitating health issues.
In dogs, which can also be infected, the signs mirror those in humans but often focus on heart-related symptoms. Early signs include lethargy, fever, pale gums, enlarged lymph nodes, and irregular heart rhythms. Chronic infection in dogs can lead to exercise intolerance, coughing, fluid buildup in the abdomen, fainting, and sudden death due to heart failure.
Recognizing the early signs of Chagas disease, especially the distinctive swelling around the eye (Romaña’s sign) and the chagoma lesion, is crucial for timely diagnosis and treatment. Without treatment in the acute phase, the parasite can silently cause long-term damage that becomes difficult to manage. Treatment is most effective when started early, aiming to eliminate the parasite and prevent progression to chronic complications.
