Chagas disease: a tropical infection of interest to the radiologist

Radiol Bras. 2016 Nov/Dez;49(6):V–VI This issue of Radiologia Brasileira features an interesting study on the radiological findings observed in patients with megaesophagus secondary to Chagas disease (CD), as identified on chest X-rays and esophagograms. The first point to be emphasized about that study is that, although it was conducted recently, it employed conventional radiology. Although many think otherwise, conventional radiographs continue to play a critical role in the investigation of thoracic diseases. When performed and interpreted appropriately, conventional radiology provides useful information for the characterization of lesions, in some cases being the only complementary imaging modality required. However, conventional radiographs have certain limitations, which often makes it necessary to use other imaging methods, computed tomography in particular. Another relevant aspect of the study in question is that it dealt with a disease that has a high incidence and prevalence in Latin America, especially in Brazil. Although other tropical infections, such as paracoccidioidomycosis, have been the subject of various recent publications in the radiology literature of Brazil, the radiological evaluation of CD has been neglected by researchers in the country. Even for paracoccidioidomycosis, the volume of radiological publications has been considered insufficient, given the importance of the disease. In a recent editorial, Rodrigues, referring to the lack of studies on the imaging aspects of paracoccidioidomycosis, pointed out that this “void” in the literature is largely our fault (i.e., that of researchers working in Brazil), because Brazil is the country where the disease is most common. The author also underscored the importance of studies on these types of diseases, which are typical and endemic in our country, for improving the understanding of their characteristics, thus increasing the accuracy of their diagnosis, as well as the appropriateness of the treatments instituted. Also known as American trypanosomiasis, CD is caused by the protozoan Trypanosoma cruzi, which has a high prevalence and causes significant morbidity in Latin America. Although the incidence of CD has been declining in the last decades, an extremely high number of patients still suffer from this disease. The majority of patients with chronic CD are elderly. That is because most CD patients come from areas in which the vector was eradicated three or four decades ago. Approximately 30% of individuals chronically infected with T. cruzi develop cardiac abnormalities, whereas ap-