231 Ch 231. Chagas Disease

Trypanosoma cruzi (Latin America endemic); 6-7M chronic globally; triatomine (“kissing”) bug primary vector + transfusion + vertical + oral; acute mild then 30% develop chronic cardiomyopathy + megacolon/megaesophagus decades later; benznidazole + nifurtimox treatment; transplant recipients + immunosuppression reactivation risk; USA + Europe + Japan migration changes epidemiology。