Changes

* <spoiler text="How is Chagas’ disease transmitted?">Reduviid bugs (kissing bugs) bite people while they sleep. The bug defecates on the skin and the infected bug feces is rubbed into the wound. Organisms from the infected feces can also enter the body via mucous membranes. These organisms then circulate via the blood stream to infect cells.</spoiler>

* <spoiler text="This patient had acute Chagas' disease. What would you expect to see in a patient with chronic Chagas' disease?">Chronic Chagas' disease leads to congestive heart failure. These patients commonly have right bundle branch block and/or other arrhythmias. These hearts are dilated and hypertrophied, have areas of fibrosis especially in the apex, and often contain mural thrombi. The myocardium is infiltrated with lymphocytes and macrophages and there is interstitial edema and fibrosis. This inflammatory reaction is most severe around the area of the right bundle branch. Patients may also develop megaesophagus and/or megacolon.</spoiler>

{{IPLab 11}}

[[Category: IPLab:Lab 11]]