Chagas: fisiopatología, vector y ciclo de transmisión.

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Chagas: fisiopatología, vector y ciclo de transmisión.

  1. 1. Enfermedad de Chagas: Vector, ciclo de transmisión, parásito y fisiopatología Fabián Ramiro Carreño Almánzar Estudiante de Medicina VI nivel Semillero de investigación Chagas UIS Universidad Industrial de Santander
  2. 2. El Agente EtiológicoKIRCHHOFF L V. Trypanosoma Species (AmericanTrypanosomiasis, Chagas’ Disease): Biology of Trypanosomes. Chapter 277: Principlesand practice of Infectious Disease, 7th ed.
  3. 3. Rassi -Jr A, Rassi A, Marcondes de Rezende J. American Trypanosomiasis (Chagas Disease). Infectious Disease Clinics of North America. 26(2), June 2012, Pages 275–291.Fig. 1. Taxonomy of Trypanosoma cruzi. Eukaryota, cell organisms that have a cell nucleus andspecialized organelles; Protista, a group of eukaryotic organisms (usually microorganisms),without the cardinal characteristics of plants and animals, also known as lower forms of plantsand animals; Protozoa, the lowest form of animal life (“first animals”), typically unicellular;Sarcomastigophora, protozoa that locomote by flagellae, pseudopodia, or both; Mastigophora,use flagella for motility; Zoomastigophora, animal-like flagellates; Kinetoplastida, order ofprotozoa characterized by the possession of a kinetoplast (a region rich in DNA within themitochondrion of the cell); Trypanosoma, name derived from the Greek trypano (auger, drill)and soma (body) because of their corkscrew-like motion; cruzi, speciesof Trypanosoma discovered by Carlos Chagas and named in honor of Dr Oswaldo Cruz, hismentor and a famous Brazilian bacteriologist.
  4. 4. El Agente EtiológicoKIRCHHOFF L V. Trypanosoma Species (AmericanTrypanosomiasis, Chagas’ Disease): Biology ofTrypanosomes. Capítulo 277: Principles and practice of Infectious Disease, 7th ed.
  5. 5. Trypanosoma cruzihttp://dna.kdna.ucla.edu/parasite_course-old/cruzi_files/subchapters/morphology%20and%20life%20cycle.htm
  6. 6. Tinción de Giemsa Tinción de Wright http://www.edicionesmedicas.com.ar/Actualidad/Ultimas_noticias/Enfermedades_tropicalesIncubación: 1-2 SemanasAparecen Tripomastigotes en sangreperiférica (Gota gruesa, ESP)Cronicidad 4-8 semanas (Desaparecenlos tripomastigotes de sangre, títulosde anticuerpos)
  7. 7. El vectorHernández González Yenin, González Broche Raúl. Revisión de la subfamilia Triatominae (Hemiptera: Reduviidae) en Cuba. Bol Mal Salud Amb. 2006 Dic ; 46(2): 107-114.
  8. 8. Triatominae Fuente: www.wikipedia.org Rhodnius prolixusTriatoma infestans Pastrongylus geniculatus
  9. 9. Ciclo de TransmisiónBern C. Antitrypanosomal Therapy for Chronic Chagas’ Disease. N Engl J Med 2011;364:2527-34.
  10. 10. Inmunología Infección Aguda Fig. 4. Serologic and parasitologic evolution in acute Chagas infection. (A) Untreated patients. One to 2 weeks after infection with T cruzi, individuals undergo an acute phase that lasts approximately 2 months, and is characterized by intense parasitemia, high levels of anti T cruzi IgM antibodies, and increasing levels of immunoglobulin G (IgG) antibodies; with the resolution of the acute infection, parasitemia becomes extremely low and IgG antibodies reach their maximum level, persisting elevated and lifelong. (B) Treated and cured patients. Cure at the acute phase is accompanied by clearance of parasitemia, which occurs immediately after etiologic treatment, and by seronegative conversion, which occurs after about 1 year for congenital Chagas disease and after 3 to 5 years for vector-borne Chagas disease. Treated and uncured patients present a response that is similar to that of untreated patients. Rassi -Jr A, Rassi A, Marcondes de Rezende J. American Trypanosomiasis (Chagas Disease). Infectious Disease Clinics of North America. 26(2), June 2012, Pages 275–291.
  11. 11. Inmunología Infección Crónica Fig. 5. Serologic and parasitologic evolution in chronic Chagas infection. (A) Untreated patients have low levels of circulating parasites and high levels of IgG antibodies directed against the antigens of T cruzi. (B) Treated and cured patients. Cure at the chronic phase is accompanied by clearance of parasitemia, which occurs immediately after etiologic treatment, and by seronegative conversion, which occurs after 5 to 10 years for those treated with less than 10 years after the initial infection (recent chronic infection), and after at least 20 years for those treated with more than 10 years after the initial infection (late chronic infection). Treated and uncured patients present a response that is similar to that of untreated patients. Rassi -Jr A, Rassi A, Marcondes de Rezende J. American Trypanosomiasis (Chagas Disease). Infectious Disease Clinics of North America. 26(2), June 2012, Pages 275–291.
  12. 12. InmunologíaBern C. Antitrypanosomal Therapy for Chronic Chagas’Disease. N Engl J Med 2011;364:2527-34.

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