Chronic CD patients have a significantly altered metabolomic profile. Scoring plots from principal component analysis (PCA) of positive (A) and negative (B) ionization mass spectrometry of sera from Chagas disease (CD) patients (red), post-treatment follow-up samples (green) and demographically matched CD-negative controls (blue). Samples clustered against the principal components (PC1 & PC2) are comprised of constituents (i.e., metabolites) with significantly different abundances. Five metabolites with significantly different levels in patients (fold-change ≥ ±1.5, patients/controls) were identified by liquid chromatography - high resolution tandem mass spectrometry (LC-HRMS/MS) (C). Significance levels were calculated using ANOVA and F-test. Error bars represent mean ± standard error of mean. % Abundances were normalized based on average control levels. P, F and C on the x-axis represent patient, follow-up, and control groups, respectively. Circles on the PCA plots were drawn to demonstrate sample grouping and do not represent mathematical confidence intervals.