Recommendations:
(1) Any laboratory worker with a possible laboratory exposure to Trypanosoma cruzi should be monitored for signs of infection after the exposure.
(2) Ideally all workers potentially exposed to T. cruzi should have a serum sample collected at the time of employment and immediately after the exposure.
(3) The site of inoculation should be monitored for any sign of erythema, swelling or rash.
(4) The patient's temperature should be taken daily for 4 weeks.
(5) Any febrile illness that occurs during the next 6 months should be evaluated.
(6) Monitor for seroconversion by testing serum every week for 8 weeks. After that monitor for seroconversion monthly for the next 4 months (months 3 to 6 after the exposure).
(7) Monitor a peripheral blood smear for parasitemia 2 or more times per week for 4 or more weeks. Monitor the peripheral blood smear if the patient develops clinical manifestations.
(8) The protocol should be modified for a patient receiving presumptive short-term therapy, looking for relapse once therapy is stopped.
A patient who seroconverts or who develops signs of infection should undergo treatment.
Additional tests that may be helpful in certain situations:
(1) PCR
(2) tissue examination
(3) hemoculture
(4) animal inoculation or xenodiagnosis
