Chagasic meningoencephalitis: case report of a recently included AIDS-defining illness in Brazil

Madalosso, Geraldine; Pellini, Alessandra Cristina Guedes; Vasconcelos, Marileide J.; Ribeiro, Ana Freitas; Weissmann, Leonardo; Filho, Gilberto Silva Oliveira; Oliveira, Augusto César Penalva de; Vidal, José Ernesto

doi:10.1590/s0036-46652004000400005

Cited by 31 publications

(16 citation statements)

References 20 publications

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“…Other authors utilized the PCR for lineage specifications of the parasite isolated by other methods 62,64,73 . The study of the parasite on a direct way took as reference, mainly, the peripheral blood and liquor. However, the utilized method was not specified in some articles 29,30,32,70 . Yet, the research between slide and cover slip of fresh material, thick smear with May-GrunwaldGiemsa coloration, Strout, microhematocrit and buffy-coat was reported in several studies in order to increase the sensitivity when verifying the presence of the protozoa 23,33,39,42,45,46,63,68,81 , not having, however, in any of those reference to the superiority of this methods compared to the study of the parasite directly on fresh material.…”

Section: Casesmentioning

confidence: 99%

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Almeida

Ramos

Correia

et al. 2011

Rev. Soc. Bras. Med. Trop.

114

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Introduction:The co-infection Trypanosoma cruzi/HIV has been described as a clinical event of great relevance. The objective of this study was to describe clinical and epidemiological aspects published in literature. Methods: It is a systematic review of a descriptive nature from the databases Medline, Lilacs, SciELO, Scopus, from 1980 to 2010. Results: There were 83 articles (2.8 articles/year) with a total of 291 cases. The co-infection was described in 1980 and this situation has become the defining AIDS clinical event in Brazil. This is the country with the highest number of publication (51.8%) followed by Argentina (27.7%). The majority of cases are amongst adult men (65.3%) native or from endemic regions with serological diagnosis in the chronic stage (97.9%) and indeterminate form (50.8%). Both diseases follow the normal course, but in 41% the reactivation of the Chagas disease occurs. The most severe form is the meningoencephalitis, with 100% of mortality without specific and early treatment of the T. cruzi. The medication of choice was the benznidazole on doses and duration normally used for the acute phase. The high parasitemia detected by direct or indirect quantitative methods indicated reactivation and its elevation is the most important predictive factor. The lower survival rate was related to the reactivation of the Chagas disease and the natural complications of both diseases. The role of the antiretroviral treatment on the co-infection cannot yet be defined by the knowledge currently existent. Conclusions: Despite the relevance of this clinical event there are still gaps to be filled.

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Section: Casesmentioning

confidence: 99%

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Almeida

Ramos

Correia

et al. 2011

Rev. Soc. Bras. Med. Trop.

114

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“…In areas of endemicity, reactivated Chagas' disease may be the first presentation of HIV infection (20), and the lethality of T. cruzi-HIV coinfection is high (369). In regions where the disease is endemic, reactivation of latent Chagas' disease not only occurs in patients infected with HIV (118,201,476,496) but also has been reported for those with leukemia (9) or lymphoma (208) and transplant recipients (8,40,216).…”

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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“…Otras manifestaciones menos frecuentes son la peritonitis www.sochinf.cl Caso Clínico espontánea 16 con identificación de tripomastigotes de T. cruzi en el líquido ascítico y la diarrea crónica con identificación de amastigotes de T. cruzi en biopsias duodenales 17 . Las lesiones cerebrales en la enfermedad de Chagas son clínica y radiológicamente indistinguibles de otros procesos neurológicos que afectan a pacientes con SIDA 13 . El primer diagnóstico diferencial es la toxoplasmosis cerebral, aunque deben considerarse otros como la leucoencefalopatía multifocal progresiva, tuberculomas, criptococomas, nocardiosis, abscesos piógenos y linfoma primario del SNC 15 .…”

Section: Discussionunclassified

Enfermedad de Chagas en el sistema nervioso central en paciente con infección por VIH: dificultades diagnósticas y terapéuticas

Sánchez-Cunto

Velázquez

et al. 2017

Rev. chil. infectol.

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Chagas disease (ChD), caused by the protozoan Trypanosoma cruzi, is an endemic anthropozoonosis in Latin America, linked to deficients socio-economic and cultural aspects and is considered one of the neglected tropical diseases. We report a fatal case of Chagas disease reactivation with central nervous system involvement in a patient with HIV infection, whose diagnosis was confirmed by positive PCR (polymerase chain reaction) test of blood, with treatment response efficiency with benznidazol and management and etiologic treatment was difficult due to limited number of antitrypanosomal drugs and the occurrence of frequent and serious adverse effects.

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Chagasic meningoencephalitis: case report of a recently included AIDS-defining illness in Brazil

Cited by 31 publications

References 20 publications

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010)

Importance of Nonenteric Protozoan Infections in Immunocompromised People

Enfermedad de Chagas en el sistema nervioso central en paciente con infección por VIH: dificultades diagnósticas y terapéuticas

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