Acute oral Chagas disease following armadillo blood ingestion: a case report

ABSTRACT A 70-year-old man from rural Colombia presented with new-onset atrial fibrillation, dyspnea, and palpitations. A peripheral blood smear revealed a Trypanosoma cruzi trypomastigote, which was confirmed by molecular testing. He reported ingesting armadillo blood 3 weeks earlier, identifying oral transmission as the likely route. Treatment with nifurtimox, oral metoprolol, and enoxaparin resulted in conversion to sinus rhythm and symptomatic improvement, although a parasitological cure could not be confirmed. Because the patient had several competing risk factors for atrial fibrillation-advanced age, long-standing hypertension, heavy smoking, and active small-cell lung carcinoma-a causal relationship with the infection could not be established. Acute Chagas disease was therefore proposed only as a possible, potentially reversible contributing factor. To our knowledge, this is among the few reported cases of acute oral Chagas disease presenting as reversible atrial fibrillation, highlighting an underrecognized cultural risk practice in non-endemic settings.