Chagasic megaesophagus in coinfection with tuberculosis: diagnostic experience

Authors

DOI:

https://doi.org/10.61997/bjm.v13i2.412

Keywords:

Chagas disease, deglutition disorders, tuberculosis, megaesophagus, manometry

Abstract

Chagas disease is associated with late complications, including chagasic megaesophagus that manifests with dysphagia, odynophagia and/or regurgitation; diagnosis by radiography, endoscopy, barium esophagram and manometry. A 70-year-old male patient presents with dysphagia from solids to liquids, regurgitation, decreased appetite and weight loss, fever, dyspnea on small exertion, productive cough. Chest X-ray impresses suspicion of megaesophagus, contrasted CT scan of the chest shows right parapneumonic pleural effusion, consolidated pneumonic significant high-risk origin of bronchial aspiration and dilatation of the esophageal body; Barium esophagogram shows a decrease in the caliber of the distal esophagus from the gastroesophageal junction, serology (ELISA) positivity for IgG antibodies to T. cruzi; and GeneXpert positive Mycobacterium Tuberculosis. The diagnosis of chagasic megaesophagus was incidental, although limited, there is evidence of Chagas disease in coinfection with pulmonary tuberculosis; It should be suspected in patients with chronic respiratory symptoms and dysphagia.

Downloads

Download data is not yet available.

References

Nguyen T, Waseem M. Chagas Disease. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Muhammad Waseem declares no relevant financial relationships with ineligible companies.2023. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29083573

Borges Migliavaca C, Stein C, Colpani V, Rene Pinto de Sousa Miguel S, Nascimento Cruz L, Oliveira Dantas R, et al. Isosorbide and nifedipine for Chagas' megaesophagus: A systematic review and meta-analysis. PLoS Negl Trop Dis. 2018;12(9):e0006836. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/30265663. DOI: https://doi.org/10.1371/journal.pntd.0006836

Candia-Puma MA, Machaca-Luque LY, Roque-Pumahuanca BM, Galdino AS, Giunchetti RC, Coelho EAF, et al. Accuracy of Diagnostic Tests for the Detection of Chagas Disease: A Systematic Review and Meta-Analysis. Diagnostics (Basel). 2022;12(11). Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/36359595. DOI: https://doi.org/10.3390/diagnostics12112752

Bierrenbach AL, Quintino ND, Moreira CHV, Damasceno RF, Nunes M, Baldoni NR, et al. Hospitalizations due to gastrointestinal Chagas disease: National registry. PLoS Negl Trop Dis. 2022;16(9):e0010796. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/36121897. DOI: https://doi.org/10.1371/journal.pntd.0010796

Beatty NL, Alcala RF, Luque NA, Radetic M, Joshi-Guske P, Alakrad E, et al. Case Report: Chagas Disease in a Traveler Who Developed Esophageal Involvement Decades after Acute Infection. Am J Trop Med Hyg. 2023;108(3):543-7. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/36646072. DOI: https://doi.org/10.4269/ajtmh.22-0461

Carbajal-de-la-Fuente AL, Sanchez-Casaccia P, Piccinali RV, Provecho Y, Salva L, Meli S, et al. Urban vectors of Chagas disease in the American continent: A systematic review of epidemiological surveys. PLoS Negl Trop Dis. 2022;16(12):e0011003. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/36516183. DOI: https://doi.org/10.1371/journal.pntd.0011003

Suarez C, Nolder D, Garcia-Mingo A, Moore DAJ, Chiodini PL. Diagnosis and Clinical Management of Chagas Disease: An Increasing Challenge in Non-Endemic Areas. Res Rep Trop Med. 2022;13:25-40. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/35912165 DOI: https://doi.org/10.2147/RRTM.S278135

Suárez-Merchán E, Ariza-Parra E, Cantillo-Barraza O, Hernández-Arango A, Cardeño-Sánchez J, Villa-Franco J. Enfermedad de Chagas aguda Experiencia diagnóstica a través de un brote. Acta Med Colomb. 2023;48(2):1-4. Disponible en: https://doi.org/10.36104/amc.2023.2727 DOI: https://doi.org/10.36104/amc.2023.2727

Maldonado J. Caracterización de donadores seropositivospor Trypanosoma cruzi y su manejo, Banco de Sangre, Hospital Escuela, Tegucigalpa, 2016. Rev Med Hondur. 2019;87(1):7-11. Disponible en: https://doi.org/10.5377/rmh.v87i1.11926 DOI: https://doi.org/10.5377/rmh.v87i1.11926

Duque Montoya D, Ospina Ríos J. Enfermedad de Chagas y sus manifestaciones neurológicas. Acta Neurol Colomb. 2021;37(1):154-62. Disponible en: https://doi.org/10.22379/24224022348 DOI: https://doi.org/10.22379/24224022348

do Carmo Neto JR, Guerra RO, Rodrigues WF, da Silva MV, Machado JR. Neuroprotective Treatments for Digestive Forms of Chagas Disease in Experimental Models: A Systematic Review. Oxid Med Cell Longev. 2022;2022:9397290. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/36199427 DOI: https://doi.org/10.1155/2022/9397290

Farina M, Buhk A, Collante A. Acalasia y Megaesófago. Rev Cir Parag. 2011;35(1):9-15. Disponible en: https://sopaci.org.py/wp/wp-content/uploads/2016/03/FarinaMiguel-oct11.pdf

Vasconez-Gonzalez J, Izquierdo-Condoy JS, Fernandez-Naranjo R, Gamez-Rivera E, Tello-De-la-Torre A, Guerrero-Castillo GS, et al. Severe Chagas disease in Ecuador: a countrywide geodemographic epidemiological analysis from 2011 to 2021. Front Public Health. 2023;11:1172955. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/37143984. DOI: https://doi.org/10.3389/fpubh.2023.1172955

Salinas D, Moreno D, Dennis R. Tuberculosis pulmonar, esofágica y laríngea. Acta Med Colomb. 2014;39(1):1-5. Disponible en: https://doi.org/10.36104/amc.2014.126. DOI: https://doi.org/10.36104/amc.2014.126

Becerra Ibarra M, Manrique M, Padrón Arrendado G, Ortíz Gasca J. Megaesófago en la enfermedad de Chagas. Informe de un caso. Rev Hosp Jua Mex. 2001;68(1):31-6. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=74841

Published

30-05-2024

How to Cite

Maldonado Triminio, J. O. (2024). Chagasic megaesophagus in coinfection with tuberculosis: diagnostic experience. Belize Journal of Medicine, 13(2). https://doi.org/10.61997/bjm.v13i2.412

Issue

Section

Case Reports