A neonate or infant may be infected in utero with Trypanosoma cruzi (vertical transmission). This can be a serious infection that may not be readily diagnosed if it occurs in a country where the infection is not endemic and the mother is not known to be infected.
A significant percentage of congenitally infected infants are asymptomatic. A symptomatic infant may have syndrome that ranges from mild to severe and life-threatening.
Symptomatic neonates may show:
(1) hepatosplenomegaly
(2) skin rash
(3) lymphadenopathy
(4) fever
(5) meningoencephalitis
(6) myocarditis
(7) pneumonitis
(8) megaviscera (esophagus, colon, etc)
(9) neonatal death
When to suspect that an infection may be congenital:
(1) absence of suitable exposure history (living in a country free of T. cruzi), especially if there is evidence that the mother was infected
(2) evidence of parasites in the placenta
(3) positive test collected soon after birth
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