Chagas disease physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Yazan Daaboul, M.D.

Overview

On physical examination, Chagas disease may manifest with fever, tachycardia, cardiac rhythm abnormalities, hepatosplenomegaly, and lymphadenopathy. Romaña's sign, a classical sign of Chagas disease, is characterized by eyelid sweilling at the site of parasitic entry. Other signs on physical examination are usually due to either cardiac or GI manifestations of the disease.

Physical Examination

Vital signs

• Fever
• Tachycardia
• Bradycardia
• Tachypnea
• Irregular pulse

Skin

• Insect bite wound
• Excoriations due to scratching at site of insect bite

HEENT

• Romaña's sign (swelling of the eyelids at the site of parasitic entry)

This child from Panama is suffering from Chagas' disease manifested as an acute infection with swelling of the right eye (Romaña's sign). Source: CDC.

• Lower extremity edema

Neck

• Cervical lymphadenopathy
• Jugular venous distention

Cardiac

Positive cardiac findings are due to development of Chagas cardiomyopathy

• S3 or S4 heart sounds
• Displaced point of maximal impulse (PMI)

To view a comprehensive list of physical exam signs of congestive heart failure, click here

Abdomen

• Hepatosplenomegaly
• Abdominal tenderness