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Recurrent PVL MSSA — SCE Infectious Diseases MCQ

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HardInfection Prevention & ControlRecurrent PVL MSSASCE Infectious Diseases

A 34-year-old Bolivian woman has chronic Trypanosoma cruzi infection confirmed by two different serological assays. ECG, echocardiography and gastrointestinal assessment show no organ damage; she is not pregnant and renal and hepatic function are normal. Which approach best reflects WHO guidance?

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Correct answer: C — Offer trypanocidal treatment after discussing reduced efficacy in chronic infection and frequent adverse effects

Explanation lettering: E = shown as A · D = shown as C · C = shown as D · A = shown as E

D is correct. WHO advises offering benznidazole or nifurtimox to infected adults, particularly those without established organ damage, while explicitly balancing a course lasting up to about two months against adverse reactions that occur in a substantial minority. A is too absolute: efficacy falls with duration of infection but is not zero. B invents lifelong prophylaxis. C reverses the therapeutic logic because established visceral damage is not repaired by parasite clearance and evidence for preventing later cardiac events is weaker once cardiomyopathy is advanced. Pregnancy and significant renal or hepatic failure would alter eligibility, but none is present here.

Reference: WHO: Chagas disease fact sheet: https://www.who.int/news-room/fact-sheets/detail/chagas-disease-%28american-trypanosomiasis%29