- Someone from Brazil has lived for 10 years in Belgium. One day he suddenly develops pain in his right leg. The leg is pale, cold and no arterial pulsations can be felt in the foot. Could this have something to do with Chagas’ disease? Is urgent therapy with Lampit® advisable?
- Why is oesophageal sphincter dilation beneficial in Chagas’ disease if the oesophagus is already distended?
- A mother who is seropositive (for Chagas’ disease) gives birth to her first child. She asks you if you know what the chances are that the baby is infected, and how you can test for that. Is congenital infection serious?
- Belgium. A 50-year-old man consults you about palpitations. He lived for 7 years in a region endemic for Chagas’ disease. Buffy coat, thin blood smear and thick smear are all negative. What do you think?
- Brazil. A 27-year-old woman suddenly develops fever and pain on the left side of her face. The skin is warm and red, and a few days later the left eyelid also swells up. Differential diagnosis?
- A colleague from southern Peru claims that Chagas’ disease only causes cardiac problems. Another colleague from Nicaragua says that Chagas’ disease is a highly exaggerated infection which, when it occurs, is almost always asymptomatic. A third person from southern Brazil disagrees totally and claims that swallowing disorders and heart problems are just as important and both are common. What is your contribution to this discussion?
- Brazil. Why should improvement in the housing in a region reduce the incidence of Chagas’ disease?
- Brazil. A man complains of chronic constipation and cough at night. The previous year he suffered a severe pulmonary infection 4 times. You find no trypanosomes in his blood. What do you think and what do you do?
- A 23-year-old woman is brought to a hospital in Paraguay. She has fever, the spleen is enlarged and the blood pressure is 90/60. Should you begin Lampit® immediately?
- Brazil. A 68-year-old man is admitted due to acute discomfort of his whole left calf and foot. At physical examination the leg is colder than the right one. It is pale and when asked the patient reports paraesthesia. After a few hours there is loss of strength and he reports pain. Both femoral arteries are normal. The arteria dorsalis pedis is not palpable at the dorsum of the foot and the arteria tibealis posterior behind the inner ankle is also not pulsating. Do you suspect occlusion of the arteria femoralis superficialis? If so, where will the embolus probably be? What might be the underlying disease?
