Bittencourt A L, Vieira G O, Tavares H C, Mota E, Maguire J
Am J Trop Med Hyg. 1984 Jan;33(1):30-3. doi: 10.4269/ajtmh.1984.33.30.
A full-term infant developed dysphagia, vomiting, and regurgitation immediately after birth. On examination at 5 months of age, he was malnourished and had radiographically proven megaesophagus. On direct examination his blood was positive for Trypanosoma cruzi. Additionally an enzyme immunoassay for T. cruzi IgM antibodies was positive. He underwent corrective surgery for the megaesophagus but died post-operatively of aspiration pneumonia. At autopsy, the esophagus was markedly dilated. There was an extreme reduction of neurons in Auerbach's plexus, and inflammation of this plexus and the muscular layer of the esophagus. Nests of parasites were seen in the esophagus and bladder. It is suggested that this patient was not in the chronic phase of Chagas' disease but represents an acute digestive phase of this infection. This is the fourth case in the literature of congenital Chagas' disease with esophageal involvement and clinical signs, and the first in which megaesophagus was seen grossly at post-mortem examination.
一名足月儿出生后立即出现吞咽困难、呕吐和反流。在5个月大时检查发现，他营养不良，经影像学检查证实患有巨食管症。直接检查时，他的血液中克氏锥虫呈阳性。此外，克氏锥虫IgM抗体的酶免疫测定也呈阳性。他接受了巨食管症的矫正手术，但术后死于吸入性肺炎。尸检时，食管明显扩张。奥尔巴赫神经丛中的神经元极度减少，该神经丛和食管肌层有炎症。在食管和膀胱中发现了寄生虫巢。提示该患者并非处于恰加斯病的慢性期，而是代表了这种感染的急性消化期。这是文献中第四例伴有食管受累和临床症状的先天性恰加斯病病例，也是第一例在尸检时肉眼可见巨食管症的病例。
