An acute<unk>  infection with swelling of the right eye (Romaña's sign)<unk>  occurs in two stages: an acute stage, which develops one to two weeks after the insect bite, and a chronic stage, which develops over many years. The acute stage is often symptom-free. When present, the symptoms are typically minor and not specific to any particular<unk> . Signs and symptoms include fever, malaise, headache, and enlargement of the liver, spleen, and lymph nodes. Sometimes, people develop a swollen nodule at the site of infection, which is called "Romaña's sign" if it is on the eyelid, or a "chagoma" if it is elsewhere on the skin. In rare cases (less than 1–5%), infected individuals develop severe acute<unk> , which can involve inflammation of the heart muscle, fluid accumulation around the heart, and inflammation of the brain and surrounding tissues, and may be life-threatening. The acute phase typically lasts four to eight weeks and resolves without treatment. Unless treated with antiparasitic drugs, individuals remain infected with after recovering from the acute phase. Most chronic infections are asymptomatic, which is referred to as indeterminate chronic<unk> . However, over decades with the<unk> , approximately 30–40% of people develop organ dysfunction (determinate chronic<unk> , which most often affects the heart or digestive system. The most common long-term manifestation is heart<unk> , which occurs in 14–45% of people with chronic<unk> . People with<unk>  heart<unk>  often experience heart palpitations, and sometimes fainting, due to irregular heart function. By electrocardiogram, people with<unk>  heart<unk>  most frequently have arrhythmias. As the<unk>  progresses, the heart's ventricles become enlarged (dilated cardiomyopathy), which reduces its ability to pump blood. In many cases the first sign of<unk>  heart<unk>  is heart failure, thromboembolism, or chest pain associated with abnormalities in the microvasculature. Also common in chronic<unk>  is damage to the digestive system, which affects 10–21% of people. Enlargement of the esophagus or colon are the most common digestive issues. Those with enlarged esophagus often experience pain (odynophagia) or trouble swallowing (dysphagia), acid reflux, cough, and weight loss. Individuals with enlarged colon often experience constipation, and may develop severe blockage of the intestine or its blood supply. Up to 10% of chronically infected individuals develop nerve damage that can result in numbness and altered reflexes or movement. While chronic<unk>  typically develops over decades, some individuals with<unk>  (less than 10%) progress to heart damage directly after acute<unk> . Signs and symptoms differ for people infected with through less common routes. People infected through ingestion of parasites tend to develop severe<unk>  within three weeks of consumption, with symptoms including fever, vomiting, shortness of breath, cough, and pain in the chest, abdomen, and muscles. Those infected congenitally typically have few to no symptoms, but can have mild non-specific symptoms, or severe symptoms such as jaundice, respiratory distress, and heart problems. People infected through organ transplant or blood transfusion tend to have symptoms similar to those of vector-borne<unk> , but the symptoms may not manifest for anywhere from a week to five months. Chronically infected individuals who become immunosuppressed due to HIV infection can suffer particularly severe and distinct<unk> , most commonly characterized by inflammation in the brain and surrounding tissue or brain abscesses. Symptoms vary widely based on the size and location of brain abscesses, but typically include fever, headaches, seizures, loss of sensation, or other neurological issues that indicate particular sites of nervous system damage. Occasionally, these individuals also experience acute heart inflammation, skin lesions, and<unk>  of the stomach, intestine, or peritoneum.
Chagas disease
Loa loa filariasis
Cyclosporiasis
Tylosis
Isosporiasis
Cryptosporidiosis
Paragonimiasis
Strongyloidiasis