On physical examination, Chagas disease may manifest with fever, tachycardia, cardiac rhythm abnormalities, hepatosplenomegaly, and lymphadenopathy. Romaña’s sign, a classical sign of Chagas disease, is characterized by eyelid sweilling at the site of parasitic entry. Other signs on physical examination are usually due to either cardiac or GI manifestations of the disease.

• Fever
• Tachycardia
• Bradycardia
• Tachypnea
• Irregular pulse

• Insect bite wound
• Excoriations due to scratching at site of insect bite

• Romaña’s sign (swelling of the eyelids at the site of parasitic entry)

• Lower extremity edema

• Cervical lymphadenopathy
• Jugular venous distention

Positive cardiac findings are due to development of Chagas cardiomyopathy

• S3 or S4 heart sounds
• Displaced point of maximal impulse (PMI)

To view a comprehensive list of physical exam signs of congestive heart failure, click here

• Hepatosplenomegaly
• Abdominal tenderness