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Introduction: Benznidazole (BZL) and Nifurtimox (NFX) are the pharmacological treatment for acute phase Chagas Disease (CD); however, therapy resistance and residual mortality development remain important unresolved issues. Posaconazole (POS) has shown a trypanocidal effect in vivo and in vitro. Thus, this study aimed at comparing the T. Cruzi parasitic load-reducing effect of the combination of BZL+POS against that of monotherapy with either, during acute phase CD, in an experimental murine model. Methods: Nineteen Wistar rats were randomly allocated to four groups and inoculated with the trypomastigotes of T. cruzi strain´s JChVcl1. The rats were administered anti-parasites from day 20-29 post-infection. The Pizzi and Brener method was used for parasitemia measurement. Longitudinal data analysis for the continuous outcome of repeated measures was performed using parasitemia as the outcome measured at days 20, 22, 24, 27, and 29 post-infection. Results: All four groups had similar parasitic loads (p=0.143) prior to therapy initiation. Among the three treatment groups, the BZL+POS (n=5) group showed the highest mean parasitic load reduction (p=0.000) compared with the control group. Likewise, the BZL+POS group rats showed an earlier therapeutic effect and were the only ones without parasites in their myocardial samples. Conclusions: Treatment of acute phase CD with BZL+POS was more efficacious at parasitemia and myocardial injury reduction, compared with monotherapy with either.

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A 32-year-old man presented with a 7-month history of progressive painless, nonpruritic skin and soft tissue lesion on his left leg. He had no systemic or B symptoms. The physical examination showed a violaceus lesion soft in consistency on the left leg (Figures 1 and 2).MRI showed an oval lesion with hypointensity signal in T1 and hyperintensity in T2, with homogeneous enhance postcontrast study, and diffusion-restriction. There was no palpable lymphadenopathy or hepatosplenomegaly. The skin lesion was biopsied and showed atypical cells (Figure 3). Immunohistochemical analysis showed cells that were positive for CD4, CD56, CD123, SPIB, TdT, and negative for MNDA (Figure 4), which supported the diagnosis of blastic plasmacytoid dendritic-cell neoplasm (BPDCN). Complete blood count was unremarkable and peripheral blood smear did not show immature cells. Bone marrow aspirate/biopsy did not reveal the presence of neoplastic plasmacytoid dendritic cells. An 18 (F)-FDG-PET- F I G U R E 1 Extensive violaceus lesion on the internal side of the left legThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.