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In vitro delayed hypersensitivity was studied in patients with either the chronic or the indeterminate phase of Chagas' disease. Normal healthy individuals were used as controls. The leucocyte migration inhibition test was applied using as antigen an extract of culture forms of T. cruzi or an extract of normal rat heart. The results showed that patients with the chronic phase of the disease reacted significantly with both antigens, whereas most patients with the indeterminate phase did not react with heart antigen and only five out of fourteen (35%) reacted with T. cruzi antigen. It is suggested that these individuals may represent patients about to develop the chronic phase of the disease. The relevance of these findings to the immune mechanism influencing the onset of the chronic phase of Chagas' disease is discussed. [ABSTRACT FROM AUTHOR]

Myocarditis is not an uncommon finding in autopsy series of patients with AIDS, although clinically important myocarditis is rarely noted. We describe a 50-year-old woman with AIDS and chronic chagasic megaesophagus, without previous cardiac abnormalities, who experienced reactivation of Chagas' disease, characterized by the finding of Trypanosoma cruzi via direct microscopic examination of the buffy coat, xenodiagnosis, and blood culture; she developed fatal acute myocarditis. Reactivation of Chagas' disease in patients with AIDS has been reported, but in the great majority of cases it has been associated with central nervous system involvement. In areas where Chagas' disease is endemic, reactivation may occur in patients with AIDS. [ABSTRACT FROM PUBLISHER]