Since heart transplantation requires immunosuppression, there is a risk of reactivated Chaga's disease following a heart transplant.
Monitoring for reactivation should occur before and after the transplant. Monitoring after the transplant varies. One schedule is weekly for the first 2 months, then monthly for the first year.
Testing may include:
(1) endomyocardial biopsy (if myocarditis is suspected)
(2) skin biopsy (if there are skin lesions or subcutaneous nodules)
(3) CSF exam (if neurologic symptoms including meningoencephalitis)
(4) bone marrow biopsy (if bone marrow involvement testing)
(5) peripheral blood smear
Serological tests are most useful for seronegative patients receiving organs from seropositive donors (Andreade et al, page 25).
Examinations may include:
(1) PCR
(2) immunohistochemistry
(3) Giemsa stain
(4) xenodiagnosis or culture
Differential diagnosis:
(1) toxoplasmosis
(2) rejection
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