Chagas disease, sometimes called the kissing bug, can cause symptoms such as fever, headache, fatigue, chagoma (a boil-like skin lesion), and Romaña’s sign, which is swelling of the eyelids.
This condition is caused by the parasite Trypanosoma cruzi. It can be transmitted through contact with the feces of an infected kissing bug, by eating food contaminated with the parasite, or from mother to baby during pregnancy or childbirth.
If kissing bug symptoms are present, it is important to see a primary care doctor or an infectious disease specialist for a complete evaluation. When needed, treatment may include antiparasitic medications such as benznidazole or nifurtimox.
Symptoms of Chagas disease
The most common kissing bug symptoms include:
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Persistent fever
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Headache
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Extreme fatigue
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Swelling of the legs and face
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Chagoma, a painful red skin lesion that looks like a boil
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Romaña’s sign, or swelling of the eyelids
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Diarrhea
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Nausea and vomiting
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Loss of appetite
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Body aches
The acute phase of Chagas disease typically lasts about 2 months after infection. Symptoms may or may not appear during this stage. Without treatment, the disease can progress to the chronic phase, which may last for decades or even a lifetime. In this phase, serious complications can develop, such as an enlarged heart, heart failure, cardiac arrest, or enlargement of the esophagus, liver, spleen, or colon.
How to know if you have Chagas disease
To determine if Chagas disease is present, a primary care doctor or infectious disease specialist will review symptoms and signs, along with factors such as eating habits and travel history.
Blood tests may be ordered, including a complete blood count (CBC), PCR, or parasite detection through thick blood smear or Giemsa-stained smear. Imaging tests such as abdominal ultrasound, chest X-ray, and echocardiogram may also be used to check for complications.
Treatment options
Treatment for Chagas disease usually involves benznidazole. The dosage depends on age and body weight:
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Adults: 5 mg per kg of body weight per day, divided into 1 to 3 doses for 60 days, or 300 mg per day divided into 2 to 3 doses for up to 80 days.
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Children and adolescents: 5 to 10 mg per kg of body weight per day, divided into 2 doses for 60 days.
If benznidazole is not well tolerated, nifurtimox may be prescribed. The recommended dose is 10 mg per kg of body weight per day for adults, and 15 mg per kg of body weight per day for children and adolescents, divided into 3 doses for 60 days.
Can Chagas disease be cured?
Chagas disease can be cured if treatment begins early, during the acute phase of infection. In the chronic phase, the disease cannot be cured, but treatment can help slow or prevent its progression and reduce the risk of mother-to-child transmission.