Late Reactivation of Chagas’ Disease Presenting in a Recipient as an Expansive Mass Lesion in the Brain after Heart Transplantation of Chagasic Myocardiopathy

Marchiori, Paulo Eurípedes; Alexandre, Paula Levatti; Britto, Nise; Patzina, Roseli A.; Fiorelli, A; Lucato, Leandro Tavares; Rosemberg, Sérgio; Pereira, Samira Luisa Apóstolos; Stolf, Noedir; Scaff, Milberto

doi:10.1016/j.healun.2007.07.043

Cited by 38 publications

(27 citation statements)

References 22 publications

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“…25 Despite this drug's effectiveness in the treatment of reactivation, 2 its prophylactic use showed no benefit for preventing reactivation and was not adopted in our study. 16 Our data also demonstrated similar survival after HTx among ChD recipients and patients with other cardiomyopathies. A Brazilian multicenter trial with more than 700 patients monitored for 10 years has found similar results.…”

Section: Discussionsupporting

confidence: 79%

“…Owing to differences between the parasite strains, gastrointestinal tract involvement is less frequent and almost exclusively seen in Argentina, Chile, Paraguay, Uruguay, and parts of Brazil. 15,16 ChD is a heterogeneous illness with a wide range of prognoses. Death usually results from cardiac involvement and rarely from gastrointestinal manifestations.…”

Section: Discussionmentioning

confidence: 99%

“…A central nervous system mass has been also reported after HTx. 16 The severity of the disease highlights the importance of early diagnosis and aggressive treatment. In our cohort, 40.0% of the patients who reactivated were asymptomatic at the time of the surveillance biopsies (Table 3).…”

Section: Discussionmentioning

confidence: 99%

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Infections in heart transplant recipients in Brazil: The challenge of Chagas' disease

Godoy

Guerra

Viegas

et al. 2010

The Journal of Heart and Lung Transplantation

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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Infections in heart transplant recipients in Brazil: The challenge of Chagas' disease

Godoy

Guerra

Viegas

et al. 2010

The Journal of Heart and Lung Transplantation

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“…In addition to fever and acute Chagas' myocarditis in the transplanted heart, common manifestations of reactivation disease include inflammatory panniculitis and skin nodules (52,102,238). Central nervous system (CNS) involvement has been reported but is a much less frequent manifestation of reactivation among transplant recipients than in AIDS patients (5,102,180).…”

Section: T Cruzi Infection In the Immunocompromised Hostmentioning

confidence: 99%

Trypanosoma cruzi and Chagas' Disease in the United States

et al. 2011

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SUMMARY Chagas' disease is caused by the protozoan parasite Trypanosoma cruzi and causes potentially life-threatening disease of the heart and gastrointestinal tract. The southern half of the United States contains enzootic cycles of T. cruzi , involving 11 recognized triatomine vector species. The greatest vector diversity and density occur in the western United States, where woodrats are the most common reservoir; other rodents, raccoons, skunks, and coyotes are also infected with T. cruzi. In the eastern United States, the prevalence of T. cruzi is highest in raccoons, opossums, armadillos, and skunks. A total of 7 autochthonous vector-borne human infections have been reported in Texas, California, Tennessee, and Louisiana; many others are thought to go unrecognized. Nevertheless, most T. cruzi -infected individuals in the United States are immigrants from areas of endemicity in Latin America. Seven transfusion-associated and 6 organ donor-derived T. cruzi infections have been documented in the United States and Canada. As improved control of vector- and blood-borne T. cruzi transmission decreases the burden in countries where the disease is historically endemic and imported Chagas' disease is increasingly recognized outside Latin America, the United States can play an important role in addressing the altered epidemiology of Chagas' disease in the 21st century.

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“…A tumor-like form of Chagas disease, with one or more granulomatous brain abscesses (chagomas) may occur in immunosuppressed patients, such as those with AIDS [10] or after organ transplantation [11]. This severe form of Chagas disease appears as a reactivation in immunosuppressed patients infected years before.…”

Section: Acute Phase Of Chagas Diseasementioning

confidence: 99%

Neurologic Manifestations of Chagas Disease

2011

Curr Neurol Neurosci Rep

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Chagas disease is endemic in Latin America and has become an emerging problem in developed countries because of international migrations. The protozoan Trypanosoma cruzi is the etiologic agent and the disease is divided into two phases. The acute phase is mostly asymptomatic or presents with unspecific symptoms. Rarely, a severe and often fatal form occurs in immunosuppressed patients or infants, characterized by meningoencephalitis (sometimes including brain tumor-like lesions) and myocarditis. The chronic phase consists of an indeterminate, asymptomatic form followed by digestive, cardiac, or neurologic symptoms in about 30% of infected patients. Autonomous nervous system dysfunction is prominent in chagasic patients and participates in the affliction of the target organs. Stroke, mainly cardioembolic, may occur in the chronic phase, but other stroke etiologies are reported. Embolic sources and inflammation are thought to play a role in stroke mechanisms. Specific treatment for Chagas disease is scarce and preventive measures are needed.

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Late Reactivation of Chagas’ Disease Presenting in a Recipient as an Expansive Mass Lesion in the Brain after Heart Transplantation of Chagasic Myocardiopathy

Cited by 38 publications

References 22 publications

Infections in heart transplant recipients in Brazil: The challenge of Chagas' disease

Infections in heart transplant recipients in Brazil: The challenge of Chagas' disease

Trypanosoma cruzi and Chagas' Disease in the United States

Neurologic Manifestations of Chagas Disease

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