Enfermedad de Chagas del sistema nervioso central en un paciente con SIDA demostrada por métodos cuantitativos moleculares

Abstract

Although infrequent, Trypanosoma cruzi reactivation is possible among patients with HIV/AIDS infection that develop a tumor-like or granulomatous lesion in the CNS. We report the case of a 60 years old male patient with HIV /AIDS and low CD4 lymphocytes count with cerebellar symptoms and mild paresis, associated to supra and infratentorial hypodense lesions and positive serology tests both to T. gondii and Trypanosoma cruzi. Empirical therapy against toxoplasmosis was prescribed together with antiretroviral therapy but without a favorable response. Brain Chagas disease was confirmed by quantitative PCR in the CSF but he died despite nifurtimox treatment. Despite its rare occurrence, Chagas disease affecting the CNS is possible among patients with HIV/AIDS infection. Epidemiological exposure, a positive Chagas serological test and the image pattern of brain lesions support the suspicion. Diagnosis can be confirmed by molecular test in CSF samples, including new quantitative methods. Despite an adverse prognosis, specific therapy can be attempted besides antiretroviral treatment.

Reactivation of Tumor-like Chagas Disease in the Central Nervous System in Cardiac Transplant Patients: A Case Series and Literature Review

“…Since then, there have been several reports of cerebral chagoma in AIDS patients. 7 8 9 10 11 12 13 14 15 16 17 The cases of cerebral chagoma non-related to AIDS found in our review are summarized in Table 1 . Among patients immunosuppressed for causes other than AIDS, the following was found: 1 patient using methotrexate due to rheumatoid arthritis; 18 2 patients with leukemia; 19 20 2 patients undergoing kidney transplantation; 21 22 and only 1 reported case of a patient who underwent a heart transplantation, 4 similar to our case.…”

Criptococosis cerebral, voriconazol, niveles plasmáticos y síndrome de reconstitución inmune. Reporte de un caso

“…Las manifestaciones pueden ser similares al cuadro inicial o con presentación de nuevos síntomas. La exclusión de otras causas requiere estudio de imágenes, estudio microbiológico del LCR con técnicas convencionales o moleculares y/o una biopsia cerebral 5,6 . Esta exclusión podría explicar por qué, a pesar de ser un fenómeno relativamente frecuente en pacientes sobrevivientes de CC [1][2][3] , los reportes nacionales sobre esta complicación sean inexistentes y la documentación de algunos casos latinoamericanos ha sido indirecta y más bien basada en una respuesta inespecífica al uso de corticoides 7 .…”

Effects of atmospheric oscillations on infectious diseases: the case of Chagas disease in Chile

“…Moreover, another main transmission way is through of vectors by fecal-urine way, however, oral way also has been described among others transmission form 18 19 , 20 , 21 …”