Diagnostic challenge

Abstract

Male patient, 12 years old, with no relevant personal history, from the Darién area. He presents to the hospital due to periodic unquantified fever, asthenia, anorexia, and weight loss lasting one month. During the last week, he has experienced progressively worsening respiratory difficulty. A chest X-ray shows cardiomegaly (Figure 1), leading to an echocardiogram that reveals severe dilation of the four cardiac chambers. Upon further questioning, the patient's family mentions that they previously lived in the Bocas del Toro area, in a wooden house, where there were bedbugs and scorpions