A 54 year old man who emigrated from Bolivia presents with progressive dysphagia, constipation, and exertional dyspnea. Examination reveals an irregular pulse, and echocardiography shows dilated cardiomyopathy. He recalls severe unilateral eyelid swelling after an insect bite as a child. Which of the following is the most likely causal organism?
- A)Giardia lamblia
- B)Trypanosoma cruziGABARITO
- C)Plasmodium falciparum
- D)Toxoplasma gondii
- E)Leishmania donovani
Explicação
Trypanosoma cruzi is correct. Chagas disease causes dilated cardiomyopathy and autonomic dysfunction leading to megaesophagus and megacolon years after infection. The history of unilateral eyelid swelling reflects Romaña sign from reduviid bug transmission. Ver explicação completa e trilha adaptativa →