Cerebral Trypanosomiasis in an Immunocompromised Patient: Case Report and Review of the Literature. World Neurosurg 2019 Sep;129:225-231
Date
06/10/2019Pubmed ID
31176839DOI
10.1016/j.wneu.2019.05.260Scopus ID
2-s2.0-85068268422 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
BACKGROUND: We document a case of central nervous system infection with Trypanosoma cruzi.
CASE DESCRIPTION: An 88-year-old woman presented with altered mental status, right-sided weakness, and slurred speech. Her medical history was significant for methotrexate intake for rheumatoid arthritis, and she tested negative for human immunodeficiency virus. Magnetic resonance imaging of the brain showed bilateral thick and peripherally enhancing white matter lesions in the frontoparietal region with extensive surrounding vasogenic edema. A lumbar puncture revealed increased protein and lymphocytic pleocytosis, and needle biopsy highlighted brain necrosis, chronic inflammation, and numerous intracellular organisms suggestive of T. cruzi amastigotes. Despite treatment with benznidazole, the patient expired soon after presentation.
CONCLUSION: Chagas disease should be included in the differential diagnosis of an immunocompromised patient presenting with a central nervous system mass, meningoencephalitis, or focal neurologic signs.
Author List
Kaushal M, Shabani S, Cochran EJ, Samra H, Zwagerman NTAuthors
Elizabeth J. Cochran MD Adjunct Professor in the Pathology department at Medical College of WisconsinNathan Zwagerman MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Aged, 80 and overArthritis, Rheumatoid
Chagas Disease
Female
Humans
Immunocompromised Host
Immunosuppressive Agents
Meningoencephalitis
Methotrexate
