Reactivation of Chagas disease with central nervous system involvement in HIV-infected patients in Argentina, 1992–2007

Córdova, Ezequiel; Boschi, Analía; Ambrosioni, Juan; Cudós, Carolina; Corti, Marcelo

doi:10.1016/j.ijid.2007.12.007

Cited by 138 publications

(142 citation statements)

References 21 publications

(27 reference statements)

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“…In relation to the clinical focus of each organ affected, this was nonspecific, ranging to the central nervous system from headache, signs of intracranial hypertension, seizures, motor location and coma, generating diagnostic confusion, mainly with toxoplasmosis and tumors of the central nervous system 37,65,66,75,84 . For the heart, it consists of triggering or exacerbating congestive heart failure, arrhythmias, atrioventricular, heart and fascicular blocks 22,27,34,42 .…”

Section: Casesmentioning

confidence: 99%

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

Almeida

Ramos

Correia

et al. 2011

Rev. Soc. Bras. Med. Trop.

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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.

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“…54 Involvement of CNS is the most frequent manifestation, occurring in 75% of coinfected patients that present reactivation. 54,56 The most common clinical symptoms are fever, headaches, vomiting, and altered consciousness; classically, coma, focal motor deficit, and convulsion can be observed as a meningoencephalitis manifestation. 54 The CNS image obtained by computed tomography is characterized by single or multiple lesions, similar to those in toxoplasmosis, predominantly located in the white matter of the brain lobes, with the occurrence of perilesional edema, deviation of midline shift, and compression of ventricules.…”

Section: Chagas Diseasementioning

confidence: 99%

“…54 The CNS image obtained by computed tomography is characterized by single or multiple lesions, similar to those in toxoplasmosis, predominantly located in the white matter of the brain lobes, with the occurrence of perilesional edema, deviation of midline shift, and compression of ventricules. [55][56][57] High mortality rate is associated in most studies. Cordova et al 56 performed a retrospective study with a total of 15 patients, in which the global mortality was 79%.…”

Section: Chagas Diseasementioning

confidence: 99%

Diagnosing Neglected Tropical Diseases in HIV Coinfection

Lindoso

Lima²,

Cunha³

et al. 2015

Human Parasitic Diseases

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“…Rarely, severe morbidities such as meningoencephalitis and cardiomyopathy have been observed [13]. Clinical features of congenital T cruzi are more severe for infants of mothers with human immunodeficiency virus (HIV)-T cruzi coinfection, including neurological sequel [14][15][16][17]. In addition, high parasitic load in umbilical cord is associated with increased severity of congenital Chagas disease in infants [13].…”

Section: Clinical Featuresmentioning

confidence: 99%

Mother-to-Child Transmission of Trypanosoma cruzi

Gebrekristos

Buekens

2014

Journal of the Pediatric Infectious Diseases Society

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Among the world's most neglected tropical diseases, Chagas disease is vector-borne and caused by Trypanosoma cruzi. T cruzi infection is endemic to South and Central America as well as Mexico. Due to population migration, T cruzi is increasingly becoming a public health problem in nonendemic settings. Success with vector control strategies has led to a relative increase in the burden attributable to congenital transmission of T cruzi. In endemic settings, approximately 5% of infected pregnant women transmit to their offspring. Congenital T cruzi infection is generally asymptomatic and parasitological and serological testing is required for diagnosis. This review highlights research gaps with a focus on (1) improving screening, diagnostic, and treatment options and (2) designing epidemiologic studies to understand risk factors for congenital T cruzi.

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Reactivation of Chagas disease with central nervous system involvement in HIV-infected patients in Argentina, 1992–2007

Abstract: ChD reactivation should be considered as a differential diagnosis of meningoencephalitis in HIV patients with low CD4 T-cell counts, previous residency in an endemic area, and/or IDUs. Whenever possible, lumbar puncture should be performed because of the high accuracy for early diagnosis.

Cited by 138 publications

References 21 publications

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

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

Diagnosing Neglected Tropical Diseases in HIV Coinfection

Mother-to-Child Transmission of Trypanosoma cruzi

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