Trypanosoma cruzi meningoencephalitis and myocarditis in a patient with acquired immunodeficiency syndrome

Rocha, Ademir; Ferreira, Marcelo S.; Nishioka, Sergio A.; Silva, Marcos; Burgarelli, Marcius K. N.; Silva, Arnaldo M.; Moura, Leandro P.; Ugrinovich, Reinaldo; Raffin, César N.

doi:10.1590/S0036-46651993000200014

Abstracts

We report the case of a 52-year-old male heterosexual patient with acquired immunodeficiency syndrome (AIDS) and reactivation of Chagas' disease manifested by meningoencephalitis and myocarditis, diagnosed post-mortem. Unexplained reactivation of Chagas' disease should be included among the diagnostic criteria of AIDS in human immunodeficiency virus positive patients. On the other hand, AIDS should be considered in the differential diagnosis of patients with unexplained reactivation of Chagas' disease.

Acquired immunodeficiency syndrome; Human immunodeficiency virus; Meningoencephalitis; Myocarditis; Trypanosomiasis; American

Relata-se o caso de um paciente de 52 anos, heterossexual, com síndrome da imunodeficiência adquirida e reativação de doença de Chagas, manifestada por meningoencefalite e miocardite diagnosticadas post mortem. Reativação inexplicada de doença de Chagas deveria estar entre os critérios para diagnóstico de AIDS em portadores do vírus da imunodeficiência adquirida. Por outro lado, o diagnóstico de AIDS deveria ser considerado em pacientes com reativação inexplicada de doença de Chagas.

CASE REPORT

Trypanosoma cruzi meningoencephalitis and myocarditis in a patient with acquired immunodeficiency syndrome

Meningoencefalite e miocardite por Trypanosoma cruzi em paciente com síndrome da imunodeficiência adquirida

Ademir Rocha; Marcelo S. Ferreira; Sergio A. Nishioka; Marcos Silva; Marcius K. N. Burgarelli; Arnaldo M. Silva; Leandro P. Moura; Reinaldo Ugrinovich; César N. Raffin

Centro de Ciências Biomédicas, Universidade Federal de Uberlândia, Av. Pará 1720. 38400 Uberlândia, Brazil

^{Address for correspondence} Address for correspondence: Ademir Rocha R. José Zacharias Junqueira 282 - Apto. 102 38400 Uberlândia, MG, Brazil

SUMMARY

We report the case of a 52-year-old male heterosexual patient with acquired immunodeficiency syndrome (AIDS) and reactivation of Chagas' disease manifested by meningoencephalitis and myocarditis, diagnosed post-mortem. Unexplained reactivation of Chagas' disease should be included among the diagnostic criteria of AIDS in human immunodeficiency virus positive patients. On the other hand, AIDS should be considered in the differential diagnosis of patients with unexplained reactivation of Chagas' disease.

Key words: Acquired immunodeficiency syndrome; Human immunodeficiency virus; Meningoencephalitis; Myocarditis; Trypanosomiasis, American.

RESUMO

Relata-se o caso de um paciente de 52 anos, heterossexual, com síndrome da imunodeficiência adquirida e reativação de doença de Chagas, manifestada por meningoencefalite e miocardite diagnosticadas post mortem. Reativação inexplicada de doença de Chagas deveria estar entre os critérios para diagnóstico de AIDS em portadores do vírus da imunodeficiência adquirida. Por outro lado, o diagnóstico de AIDS deveria ser considerado em pacientes com reativação inexplicada de doença de Chagas.

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Recebido para publicação em 10/8/1992

Aceito para publicação em 9/10/1992

1. DEL CASTILLO, M.; MENDOZA, G.; OVIEDO, J.; PEREZ BIANCO, R.P.; ANSELMO, A.E. & SILVA, M. - AIDS and Chagas' disease with central nervous system tumor-like lesion. Amer. J. Med., 88: 693-694, 1990.
2. DIAS, J.C.P. - Control of Chagas' disease in Brazil. Parasit today, 3: 336-341, 1987.
3. FERREIRA, M.S.; NISHIOKA, S.A.; ROCHA, A.; SILVA, A.M.; FERREIRA, R.G.; OLIVER, W. & TOSTES JR., S. - Acute fatal Trypanosoma cruzi meningoencephalitis in a human immunodeficiency virus-positive hemophiliac patient. Amer. J. trop. Med. Hyg., 45: 723-727, 1991.
4. GLUCKSTEIN, D.; CIFERRI, F. & RUSKIN, J. - Chagas' disease: another cause of cerebral mass in the acquired immunodeficiency syndrome. Amer. J. Med., 92: 429-432, 1992.
5. KOHL, S.; PICKERING, L.K.; FRANKEL, L.S. A YAEGER, R.G. - Reactivation of Chagas' disease during therapy of acute lymphocytic leukemia. Cancer, 50: 827-828, 1982.
6. MATTOSINHO-FRANÇA, L.C.; FLEURY, R.N.; RAMOS JR., H.A.; LEMOS, S.; MELARAGNO FILHO, R. & PASTERNAK, J. - Moléstia de Chagas crônica associada a leucemia linfática: ocorręncia de encefalite aguda como alteraçăo do estado imunitário. Arq. Neuro-psiquiatr. (S. Paulo), 27: 59-66, 1969.
7. MONTEVERDE, D.A.; TARATUTO, A.L. & LUCATELLI, N. - Meningoencefalitis chagasica aguda en pacientes inmunosuprimidos. Rev. neurol. argent., 2: 260-266, 1976.
8. ODDÓ, D.; CASANOVA, M.; ACUŃA, G.; BALLESTEROS, J. & MORALES, B. - Acute Chagas' disease (trypanosomiasis americana) in acquired immunodeficiency syndrome: report of two cases. Hum. Path., 23: 41-44, 1992.
9. PIZZI, T.; DE CROIZET, V.; SMOK, G. & DIAZ, M. - Enfermedad de Chagas en pacientes con transplante renal e inmunosupresores. Rev. méd. Chile, 110: 1207-1212, 1982.
10. RIVERO, I.; MORAVENIK, M.; MORALES, J.; GOMEZ, M. & ROSAS, J.M. - Chagas' disease: another hazard in acute leukemia. New Engl. J. Med., 290: 285, 1974.
11. ROSEMBERG, S.; CHAVES, C.J.; HIGUSHI, M.L.; LOPES, M.B.S.; CASTRO, L.H.M. & MACHADO, L.R. - Fatal meningoencephalitis caused by reactivation of Trypanosoma cruzi infection in a patient with AIDS. Neurology, 42: 640-642, 1992.
12. STOLF, N.A.G.; HIGUSHI, L.; BOCCHI, E.; BELLOTTI, G.; AULER, J.O.C.; UIP, D.; AMATO NETO, V.; PILEGGI, F. & JATENE, A.D. - Heart transplantation in patients with Chagas' disease cardiomyopathy. J. Heart Transplant., 6: 307-312, 1987.

Address for correspondence:

Ademir Rocha

R. José Zacharias Junqueira 282 - Apto. 102

38400 Uberlândia, MG, Brazil

Publication Dates

Publication in this collection
27 July 2006
Date of issue
Apr 1993

History

Received
10 Aug 1992
Accepted
09 Oct 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. DEL CASTILLO, M.; MENDOZA, G.; OVIEDO, J.; PEREZ BIANCO, R.P.; ANSELMO, A.E. & SILVA, M. - AIDS and Chagas' disease with central nervous system tumor-like lesion. Amer. J. Med., 88: 693-694, 1990.

[2] 2. DIAS, J.C.P. - Control of Chagas' disease in Brazil. Parasit today, 3: 336-341, 1987.

[3] 3. FERREIRA, M.S.; NISHIOKA, S.A.; ROCHA, A.; SILVA, A.M.; FERREIRA, R.G.; OLIVER, W. & TOSTES JR., S. - Acute fatal Trypanosoma cruzi meningoencephalitis in a human immunodeficiency virus-positive hemophiliac patient. Amer. J. trop. Med. Hyg., 45: 723-727, 1991.

[4] 4. GLUCKSTEIN, D.; CIFERRI, F. & RUSKIN, J. - Chagas' disease: another cause of cerebral mass in the acquired immunodeficiency syndrome. Amer. J. Med., 92: 429-432, 1992.

[5] 5. KOHL, S.; PICKERING, L.K.; FRANKEL, L.S. A YAEGER, R.G. - Reactivation of Chagas' disease during therapy of acute lymphocytic leukemia. Cancer, 50: 827-828, 1982.

[6] 6. MATTOSINHO-FRANÇA, L.C.; FLEURY, R.N.; RAMOS JR., H.A.; LEMOS, S.; MELARAGNO FILHO, R. & PASTERNAK, J. - Moléstia de Chagas crônica associada a leucemia linfática: ocorręncia de encefalite aguda como alteraçăo do estado imunitário. Arq. Neuro-psiquiatr. (S. Paulo), 27: 59-66, 1969.

[7] 7. MONTEVERDE, D.A.; TARATUTO, A.L. & LUCATELLI, N. - Meningoencefalitis chagasica aguda en pacientes inmunosuprimidos. Rev. neurol. argent., 2: 260-266, 1976.

[8] 8. ODDÓ, D.; CASANOVA, M.; ACUŃA, G.; BALLESTEROS, J. & MORALES, B. - Acute Chagas' disease (trypanosomiasis americana) in acquired immunodeficiency syndrome: report of two cases. Hum. Path., 23: 41-44, 1992.

[9] 9. PIZZI, T.; DE CROIZET, V.; SMOK, G. & DIAZ, M. - Enfermedad de Chagas en pacientes con transplante renal e inmunosupresores. Rev. méd. Chile, 110: 1207-1212, 1982.

[10] 10. RIVERO, I.; MORAVENIK, M.; MORALES, J.; GOMEZ, M. & ROSAS, J.M. - Chagas' disease: another hazard in acute leukemia. New Engl. J. Med., 290: 285, 1974.

[11] 11. ROSEMBERG, S.; CHAVES, C.J.; HIGUSHI, M.L.; LOPES, M.B.S.; CASTRO, L.H.M. & MACHADO, L.R. - Fatal meningoencephalitis caused by reactivation of Trypanosoma cruzi infection in a patient with AIDS. Neurology, 42: 640-642, 1992.

[12] 12. STOLF, N.A.G.; HIGUSHI, L.; BOCCHI, E.; BELLOTTI, G.; AULER, J.O.C.; UIP, D.; AMATO NETO, V.; PILEGGI, F. & JATENE, A.D. - Heart transplantation in patients with Chagas' disease cardiomyopathy. J. Heart Transplant., 6: 307-312, 1987.

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