Antitrypanosomal Therapy for Chronic Chagas' Disease
Antitrypanosomal Therapy for Chronic Chagas' Disease
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DOI：
10.1056/nejmct1014204
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发表时间：
2011-06-30
影响因子：
158.5
通讯作者：
Bern, Caryn
中科院分区：
文献类型：
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作者：
Bern, Caryn
一名42岁的妇女向她的医生提交了一封信，信中说，在她最近献血后，对她捐献的血液进行的血清学检测对恰加斯病呈阳性。患者出生于萨尔瓦多萨尔瓦多，18岁时移居美国。她的三个孩子分别为8岁、13岁和16岁。她的病史是值得注意的，只有胆囊切除术2年前，她没有报告心脏或胃肠道症状。她的体格检查没有什么异常。心电图（ECG）显示窦性心律，频率为每分钟72次，完全右冠状支传导阻滞。超声心动图显示轻度左室节段性室壁运动异常，但射血分数和左室内径正常。病人被转介给传染病顾问，他建议抗锥虫治疗。
A 42-year-old woman presents to her physician with a letter stating that after she made a recent blood donation, a serologic test of her donated blood was positive for Chagas' disease. The patient was born in El Salvador and moved to the United States when she was 18 years of age. Her three children are 8, 13, and 16 years of age. Her medical history is remarkable only for a cholecystectomy 2 years earlier; she reports no cardiac or gastrointestinal symptoms. Her physical examination is unremarkable. Electrocardiography (ECG) shows sinus rhythm at a rate of 72 beats per minute and a complete right bundle-branch block. An echocardiogram shows mild left ventricular segmental wall-motion abnormalities, but a normal ejection fraction and left ventricular diameter. The patient is referred to an infectious-disease consultant, who recommends antitrypanosomal therapy.