Utility of prenatal screening for Congenital Chagas disease

Chagas Disease is a pathology caused by the parasite Trypanosoma cruzi. It is considered a public health issue, especially its congenital transmission, not only in endemic countries but also in non-endemic ones, being the main form of transmission in Chile. Objectives: To describe a congenital Chagas Disease case and to report about the usefulness of prenatal screening for Chagas Disease. Clinical Case: A 29-week preterm newborn of a multiparous mother with Chagas Disease detected in the perinatal screening of current pregnancy. Due to history of Trypanosoma cruzi, PCR was performed on the 4th day of life resulting undetectable. At the 6th and the 8th week of life, a macular erythematous rash and fever and respiratory distress were observed, respectively, both self-limited. At the 8th week of life, as a routine prematurity follow-up, a fundus examination was performed which showed bilateral retinal granulation, therefore, a TORCH study was performed with a negative result. Also, in this same week, a second Trypanosoma cruzi PCR was performed, with a positive result. Lab tests reported visualization of trypomastigotes, confirming the Congenital Chagas Disease diagnosis. The patient was treated with Nifurtimox, presenting an adverse reaction at 35 days of treatment with neutropenia, vomiting, and poor weight gain. The treating drug was replaced by Benznidazole, achieving 60 days of treatment. At 22 months of chronologic age, the patient has remained asymptomatic. Conclusions: It is necessary to increase efforts in prevention, early detection, and study of direct relatives. This report is an example of the usefulness of Chagas disease prenatal screening for the detection and early treatment of new cases.