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== Clinical Summary ==
This 12-year-old boy, whose family had recently emigrated from Brazil, presented to the emergency room with a three-day history of malaise, fever, anorexia, and edema of the face and upper extremities. On physical examination the patient had generalized lymphadenopathy and hepatosplenomegaly. The patient was tachycardic and dysgenic with signs of congestive heart failure. A cardiac biopsy was performed which revealed an active myocarditis with leishmanial forms of parasitic organisms within cardiac myocytes. Close examination of peripheral blood smears revealed occasional circulating trypomastigotes. A complement fixation test for antibodies to Trypanosoma cruzi was strongly positive.
== Images ==
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