The findings of unilateral periorbital edema (Romana sign), painful cutaneous edema (Chagoma), lymphadenopathy, and hepatosplenomegaly are most consistent with which disease?

• A. Leishmaniasis
• B. Chagas disease (American Trypanosomiasis)
• C. Sleeping Sickness
• D. Schistosomiasis

Answer: (B)

Romana sign, the unilateral periorbital edema, is a classic early clue for acute Chagas disease. It occurs after Trypanosoma cruzi enters the body, typically via the kissing bug, when the parasite is deposited near the eye and penetrates the conjunctiva. The chagoma is the local inflammatory bump at the inoculation site, and systemic involvement can bring lymphadenopathy and hepatosplenomegaly. Taken together, these findings point to acute Chagas disease. Other diseases may cause organ enlargement or skin lesions, but they don’t produce the eye edema plus a local inoculation lesion pattern seen with Chagas disease.