Acute Chagas Disease Manifesting as Orbital Cellulitis, Texas, USA

We report a case of acute, vectorborne Chagas disease, acquired locally in central Texas, USA, manifesting as Romana's sign, which was initially mistaken for orbital cellulitis. After the infection failed to respond to antibiotics, DNA-based next generation sequencing on plasma yielded high levels of Trypanasoma cruzi; results were confirmed by PCR.

Automated summary

This case report highlights an acute, vectorborne Chagas disease acquired locally in central Texas, USA, presenting with Romana's sign initially mistaken for orbital cellulitis. Despite initial treatment with antibiotics, the infection did not respond, leading to the diagnosis confirmed by DNA-based next generation sequencing and PCR.