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Romaña Sign Chagas — SCE Infectious Diseases MCQ

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EasyTropical & Imported InfectionsRomaña Sign ChagasSCE Infectious Diseases

A 30-year-old man from South America presents with an acute febrile illness. He has a positive Trypanosoma cruzi blood smear (trypomastigotes visible). He has unilateral painless periorbital oedema with conjunctival injection on the right side. What is the name of this sign?

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Correct answer: E — Romaña sign — unilateral painless periorbital/palpebral oedema at the site of T. cruzi entry via the conjunctiva; it is pathognomonic of acute Chagas disease

Romaña sign is unilateral painless periorbital oedema with conjunctival injection, representing the portal of entry of T. cruzi via the conjunctiva (from contamination with infected triatomine bug faeces rubbed into the eye). It occurs in ~50% of acute Chagas cases with conjunctival inoculation. A chagoma (indurated skin lesion) at other inoculation sites is the cutaneous equivalent. Acute Chagas is treated with Benznidazole 5–7 mg/kg/day for 60 days or Nifurtimox for 60–90 days. Acute phase parasitaemia on blood smear confirms diagnosis.

Reference: WHO 2024 – Chagas disease; NICE CKS 2024