*5.3.2 Acute phase*

The initial acute phase lasts about 2 months after infection. During the acute phase, a large number of parasites circulate in the blood. However, most cases are asymptomatic or mild and nonspecific. In less than 50% of people bitten by triatomine bugs, the typical first sign seen can be a skin lesion or bruising and swelling on one eyelid. In addition, fever, headache, swollen lymph nodes, pallor, muscle pain,

#### *Stress-Induced Cardiomyopathy DOI: http://dx.doi.org/10.5772/intechopen.105584*

difficulty breathing, swelling, and abdominal or chest pain may also present. In the acute phase, fever (missing or intermittent), rash, hepatosplenomegaly, lymphadenopathy, and non-inflammatory edema may be present and may be limited to the face or systemic. Trypanosoma's enter tissues during or after parasemia, causing myocarditis and endocarditis, sinus tachycardia, mitral systolic murmur, cardiac hypertrophy, and meningoencephalitis. Symptoms disappear after more than 4 to 12 weeks. Severe cases are more common in neonates, young children, the elderly and immunosuppressed. Heart failure or ventricular fibrillation and meningoencephalitis caused by early myocarditis during this period can often lead to death. When more advanced electrocardiographic findings are present, including right bundle-branch block (RBBB), atrial fibrillation, or ventricular arrhythmias, they signal a worse prognosis [74].
