Re-emergence of Chagas Disease: A Case of Acute Parasitemia in Colombia

Introduction: Acute Chagas disease due to Trypanosoma cruzi is uncommon in Colombia and is difficult to suspect outside endemic areas. Timely diagnosis is crucial to prevent chronic cardiac and digestive complications.
Case presentation: A 60-year-old male with no relevant medical history presented with a 38-day history of nocturnal fever, chills, and progressive cervical and inguinal lymphadenopathy. He had recently traveled to Venezuela and worked on a farm in the Atlántico Department of Colombia. Physical examination revealed palpable lymph nodes without other abnormalities. Laboratory tests including liver function, renal function, and chest radiography were normal; blood and urine cultures were negative. A thick blood smear demonstrated Trypanosoma cruzi trypomastigotes, confirming acute infection with positive IgM serology. Cardiac evaluation was normal. Benznidazole 100 mg orally every 8 hours for 60 days was initiated, with a transient inflammatory reaction during the first week and favorable evolution without complications.
Conclusion: This case highlights the importance of considering acute Chagas disease in patients with prolonged fever and lymphadenopathy following exposure in rural or endemic areas, even in nontraditional regions of the country.