Explanted Heart Examined
The pathologist examined the explanted heart and observed the image to the right:
Challege
- What does this image illustrate in the explanted heart?
- What is the likely diagnosis?
- How would you confirm this suspected diagnosis?
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The pathology demonstrates a typical nest of T. cruzi amastigotes (each parasite contains both nucleus and kinetoplast.) The patient's cardiomyopathy is likely due to chronic Chagas disease.
The best way to confirm the diagnosis of chronic Chagas disease is by serological testing for antibody to T. cruzi.
PCR or immunohistochemistry can also be used to detect T. cruzi in tissue. However, parasites are often sparse in tissue from chronic Chagas disease patients and a negative result does not rule out the infection.
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