Chagasic Granulomatous Encephalitis in Immunosuppressed Patients; Computed Tomography and Magnetic Resonance Imaging Findings

Lorenzo, Guillermo A. Di; Pagano, Miguel Ángel; Taratuto, Ana Lía; Garau, Mariela; Meli, Francisco; Pomsztein, Marcelo D

doi:10.1111/jon19966294

Cited by 42 publications

(11 citation statements)

References 9 publications

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“…In HIV-infected individuals, the diagnosis of Chagasic brain pathologies begins with a computed tomography (CT) scan or magnetic resonance imaging (MRI) (20,174,369,567). Meningoencephalitis and myocarditis as seen for T. cruzi-HIV coinfection may be easily confused with those observed for Toxoplasma-HIV coinfections (20,522).…”

Section: Trypanosomamentioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

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SUMMARY There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.

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Section: Trypanosomamentioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

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“…D A reversed lookup table has been applied to better visualise the well-preserved parasite nuclei and kinetoplasts gas 1911; Andrade and Ramalho 1966). During reactivation of the disease, trypomastigotes may also be found in the cerebrospinal liquid (Pittella 1993;Jardim and Takayanagui 1994;Rocha et al 1994) in conjunction with brain tumours and profuse encephalitis (Gluckstein et al 1992;Rosemberg et al 1992;Pittella 1993;Rocha et al 1994;Di Lorenzo et al 1996) The use of a Mab speci®c for intracellular trypomastigote forms (Mab 3B2) allowed the visualisation of the infective form of the parasites in tissues from patients in either acute or reactivated forms of the disease. Thus, in myocardial necropsy samples of case no.…”

Section: Trypomastigotes In Tissues From Chagasic Patientsmentioning

confidence: 99%

Imaging Trypanosoma cruzi within tissues from chagasic patients using confocal microscopy with monoclonal antibodies

Mortara¹,

Silva²,

Patrı́cio

et al. 1999

Parasitology Research

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Confocal fluorescence microscopy combined with differential interference contrast imaging of tissues from chagasic patients enabled the unequivocal identification of the parasite Trypanosoma cruzi. Using different monoclonal antibodies that indicate the parasite form and replication stage in conjunction with DNA labelling, specimens derived from distinct clinical forms of the disease were examined. Intracellular amastigote forms of the parasite were clearly detected in heart, brain, skin, lung, and kidney. Dividing amastigotes as well as trypomastigote forms were recognized in samples obtained from patients undergoing either acute-phase or some form of reactivation caused by immunosuppression.

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“…Following that paper many other addressed the topic 2,5,7,9,11,18,21,27,28 . From those reports and the others presented in meetings, 29 of 75 (38.6%) patients with T. cruzi infection had reactivation involving the central nervous system (CNS).…”

mentioning

confidence: 99%

Chagasic meningoencephalitis in the immunodeficient

Lazo¹,

Meneses

Rocha

et al. 1998

Arq. Neuro-Psiquiatr.

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-Based on their own experience and on the literature, the authors compare the brain pathology due to HIV+ associated Trypanosoma cruzi reactived infection to that described for the natural history of the Chagas' disease (CD). The peculiar focal necrotizing chagasic meningoencephalitis (MECNF) which appears only in immunedeficient chagasics, especially when the deficiency is due HIV is a safe criterion for reactivation of CD. MECNF morphologic findings are unlike to those found either for some cases of acute phase CD or for chronic nervous form of CD.KEY WORDS: chagasic meningoencephalitis, encephalitis, AIDS, Trypanosoma cruzi, Chagas´ disease. Meningoencefalite chagásica no imunodeficienteRESUMO -Baseados na experiência pessoal e nos dados da literatura, os autores comparam as alterações anatomopatológicas encefálicas resultantes da reativação da infecção pelo Trypanosoma cruzi, de paciente HIV+, com aquelas observadas e descritas na história natural da doença de Chagas (DC). A meningoencefalite chagásica necrosante focal (MECNF) que somente se desenvolve em tripanosomoticos imunodeficientes, especialmente quando a imunodeficiência é devida ao HIV, tem características peculiares e constitui parâmetro anatomopatológico seguro, de reativação da DC. Esta MECNF apresenta lesões diversas daquelas que podem ser observadas e que são descritas em casos da fase aguda e da forma nervosa crônica da DC.

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Chagasic Granulomatous Encephalitis in Immunosuppressed Patients; Computed Tomography and Magnetic Resonance Imaging Findings

Cited by 42 publications

References 9 publications

Importance of Nonenteric Protozoan Infections in Immunocompromised People

Importance of Nonenteric Protozoan Infections in Immunocompromised People

Imaging Trypanosoma cruzi within tissues from chagasic patients using confocal microscopy with monoclonal antibodies

Chagasic meningoencephalitis in the immunodeficient

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