1921
Volume 96, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Central nervous system (CNS) involvement in Chagas disease (CD) is an uncommon complication that can result from direct involvement of the parasite or from thromboembolic phenomena. Direct involvement of CNS can occur in both acute and chronic forms of CD, and can also be secondary to reactivation. Reactivation of CD generally occurs in immunosuppressed patients such as those with human immunodeficiency infection or malignancies being rarely described in patients without apparent immunosuppression. We report a case of a patient living for many years in a nonendemic area for CD that presented to the emergency department with sudden onset of neurological symptoms as a result of reactivation of the disease. The microorganism was isolated from cerebrospinal fluid, and despite appropriate use of benznidazole, the patient died of sepsis after 22 days of treatment. Further investigation did not show any apparent cause of immunosuppression. This case report shows the importance of considering the diagnostic possibility of neurological complications from CD reactivation in patients that have ever lived in CD-endemic areas even without apparent underlying immunosuppression.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.16-0225
2017-02-08
2019-07-18
Loading full text...

Full text loading...

/deliver/fulltext/14761645/96/2/292.html?itemId=/content/journals/10.4269/ajtmh.16-0225&mimeType=html&fmt=ahah

References

  1. Bern C, , 2015. Chagas' disease. N Engl J Med 373: 456466.[Crossref] [Google Scholar]
  2. Da Mata JR, Camargos ERS, Chian E, Machado CRS, , 2000. Trypanosoma cruzi infection and the rat central nervous system: proliferation of parasites in astrocytes and the brain reaction to parasitism. Brain Res Bull 53: 153162.[Crossref] [Google Scholar]
  3. Pagano MA, Segura MJ, Di Lorenzo GA, Garau ML, Molina HA, Cahn P, Perez H, Vítolo F, Grondona A, Piedimonte FC, Giannuaula R, Ramia R, Miranda MA, Sierra H, Sica REP, , 1999. Cerebral tumor-like American tryoanosomiasis in acquired immunodeficiency syndrome. Ann Neurol 45: 403406.[Crossref] [Google Scholar]
  4. Pimentel PCA, Handfas BW, Carmignani M, , 1996. Trypanossoma cruzi meningoencephalitis in AIDS mimicking cerebral metastases. Arq Neuropsiquiatr 54: 102106.[Crossref] [Google Scholar]
  5. Cordova E, Maiolo E, Corti M, Orduña T, , 2010. Neurological manifestations of Chagas' disease. Neurol Res 32: 238244.[Crossref] [Google Scholar]
  6. Cordova E, Boschi A, Ambrosioni J, Cudos C, Corti M, , 2008. Reactivation of Chagas disease with central nervous system involvement in HIV-infected patients in Argentina, 1992–2007. Int J Infect Dis 12: 587592.[Crossref] [Google Scholar]
  7. Pittella JEH, , 2009. Central nervous system involvement in Chagas disease: a hundred-year-old history. Trans R Soc Trop Med Hyg 103: 973978.[Crossref] [Google Scholar]
  8. Chagas C, , 1911. Nova entidade mórbida do homem: rezumo geral dos estudos etiológicos e clínicos. Mem Inst Oswaldo Cruz 3: 219275. [Google Scholar]
  9. Prata A, , 2001. Clinical and epidemiological aspects of Chagas disease. Lancet Infect Dis 1: 92100.[Crossref] [Google Scholar]
  10. Pinazo MJ, Espinosa G, Cortes-Lletget C, Posada EJ, Aldasoro E, Oliveira I, Muñoz J, Gállego M, Gascon J, , 2013. Immunosuppression and Chagas disease: a management challenge. PLoS Negl Trop Dis 7: e1965.[Crossref] [Google Scholar]
  11. Ferreira MS, Borges AS, , 2002. Some aspects of protozoan infections in immunocompromised patients—a review. Mem Inst Oswaldo Cruz 97: 443457.[Crossref] [Google Scholar]
  12. Sica REP, Gargiullo G, Papayanis C, , 2008. Tumor-like chagasic encephalitis in AIDS patients. Arq Neuropsiquiatr 66: 881884.[Crossref] [Google Scholar]
  13. Burgos JM, Begher S, Silva HMV, Bisio M, Duffy T, Levin MJ, Macedo AM, Schijman AG, , 2008. Case report: molecular identification of Trypanosoma cruzi I tropism for central nervous system in Chagas reactivation due to AIDS. Am J Trop Med Hyg 78: 294297. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0225
Loading
/content/journals/10.4269/ajtmh.16-0225
Loading

Data & Media loading...

  • Received : 21 Mar 2016
  • Accepted : 23 Oct 2016
  • Published online : 08 Feb 2017

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error