serology for CD tested positive in September 2014. The patient was born and raised in the state of Maryland (Silver Spring) and at the age of 5 moved to Miami, Florida. The patient had no exposure to potential sources of infected vectors, such as sub-standard housing (i.e. cracks on the walls and foundations of homes made of adobe/mud, thatched roofs) and/or potential animal reservoirs and infected vectors, either in the United States or during his four visits, for less than two weeks each, to La Paz city in Bolivia. An interview with the patient's mother revealed that during his childhood, the patient never visited or stayed in high endemic rural areas for CD in Bolivia. Past medical history: In May 2013, the patient was evaluated for left sided2008 post a voluntary blood donation, and confirmed by the CDC. The patient denied previous blood transfusions and never traveled to Bolivia or any other endemic destinations in the Americas. In 2012, a new evaluation and EKG were normal. Treatment with Nifurtimox, 10 mg/kg orally daily, divided in three doses for 90 days as per CDC protocol, was provided. The patient tolerated and completed treatment. His primary care physician has followed him on a regular basis, and to date the patient has remained without evidence of active clinical disease.

The patients' mother was born and resided in the city of Concepción, Bolivia, until she was 18 years of age. She lived in a house described with mud walls and thatch. She had knowledge of the existence of the triatomine insects locally