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  #1  
Old 09-26-2011
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Question What is the diagnosis of this complicated patient?

A 50 year-old male farmer living in a village near of Cametá, Pará state, Brazil, presented with high fever, followed by chills, headache, cough, dyspnea and swelling of the legs. These symptoms occurred simultaneously with the illness of his two daughters. He was admitted to the local hospital, where a leishmaniasis indirect immunofluorescent antibody test (IFAT-IgG anti-leishmania 1/10,240) was positive. The diagnosis of visceral leishmaniasis was made and treatment with intravenous glucantime 13.1 mL/daily was initiated. He remained on this treatment for 13 days. As his symptoms progressed to congestive heart failure, he was transferred to Belém. Two days later, he was admitted to the Intensive Care Unit with cardiac tamponade, hypotension and acute renal failure. He required pericardiocentesis, endotracheal intubation, mechanical ventilation and peritoneal dialysis. He recovered from a cardiac arrest but developed severe ventricular tachycardia and died 40 days after the initial symptoms.
Heart necropsy showed a rare parasite in cardiac myocytes. What is the diagnosis and the underlying cause?


A) Acute myocarditis, Coxackievirus B
B) Acute pericarditis, Parvovirus B19
C) Acute pericarditis, Trypanosoma cruzi
D) Acute myocarditis, Trypanosoma cruzi
E) Acute myocarditis, Borrelia burgdorferi
F) Dilated cardiomyopathy, Unknown
G) Acute pericarditis, Ebsein bar virus
I) Acute myocarditis, Cryptococcus neoformans
J) Acute pericarditis, Blastoschizomyces capitus
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  #2  
Old 09-26-2011
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I go with acute pericarditis and tripanozoma cruzi.
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  #3  
Old 09-26-2011
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D) Acute myocarditis, Trypanosoma cruzi
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Old 09-26-2011
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A.coxackievirus b
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Old 09-26-2011
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I think its C, Acute myocarditis with T.cruzi
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Old 09-26-2011
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D) Acute myocarditis, Trypanosoma cruzi
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Old 09-27-2011
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yeah i will go with trypanasoma cruzi with myocarditis cuz of south america
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there is cardiac tamponade so i go with trypasanoma cruzi with acute pericarditis
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Old 09-27-2011
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Default C.

Quote:
Originally Posted by m82_ghasemi View Post
A 50 year-old male farmer living in a village near of Cametá, Pará state, Brazil, presented with high fever, followed by chills, headache, cough, dyspnea and swelling of the legs. These symptoms occurred simultaneously with the illness of his two daughters. He was admitted to the local hospital, where a leishmaniasis indirect immunofluorescent antibody test (IFAT-IgG anti-leishmania 1/10,240) was positive. The diagnosis of visceral leishmaniasis was made and treatment with intravenous glucantime 13.1 mL/daily was initiated. He remained on this treatment for 13 days. As his symptoms progressed to congestive heart failure, he was transferred to Belém. Two days later, he was admitted to the Intensive Care Unit with cardiac tamponade, hypotension and acute renal failure. He required pericardiocentesis, endotracheal intubation, mechanical ventilation and peritoneal dialysis. He recovered from a cardiac arrest but developed severe ventricular tachycardia and died 40 days after the initial symptoms.
Heart necropsy showed a rare parasite in cardiac myocytes. What is the diagnosis and the underlying cause?


A) Acute myocarditis, Coxackievirus B
B) Acute pericarditis, Parvovirus B19
C) Acute pericarditis, Trypanosoma cruzi
D) Acute myocarditis, Trypanosoma cruzi
E) Acute myocarditis, Borrelia burgdorferi
F) Dilated cardiomyopathy, Unknown
G) Acute pericarditis, Ebsein bar virus
I) Acute myocarditis, Cryptococcus neoformans
J) Acute pericarditis, Blastoschizomyces capitus
Acute pericarditis, Trypanosoma cruzi
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  #10  
Old 09-27-2011
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Correct Answer Answer

The correct answer is

D) Acute myocarditis, Trypanosoma cruzi

Note the necropsy results which shows the organism in myocytes
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