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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.38 no.4 São Paulo July/Aug. 1996

http://dx.doi.org/10.1590/S0036-46651996000400008 

TRYPANOSOMIASIS

 

Tumor-like lesion due to Chagas' disease in a patient with lymphocytic leukemia

 

Massa cerebral devido a Doença de Chagas em paciente com leucemia linfocítica

 

 

Pedro Rippel SalgadoI; Anthony Guerra GorskiII; Andréa Ribeiro AleixoIII; Eugênio Oliveira Martins de BarrosIV

IAssistant Professor of Neurology-UFMS - Universidade Federal de MS, Brazil
IIMedical Resident
IIIMedical Resident
IVAssistant Professor of Epidemiology - UFMS, Brazil

Correspondence to

 

 


SUMMARY

A 73 year-old white male, living in the interior of the state of Mato Grosso do Sul, in central Brazil, after an initial diagnosis of sinusitis was transferred to the neurology service with a 3-day evolution of intracranial hypertension.
Exams showed lymphocytic leukemia and a tumor-like lesion, either an expanding inflammatory process such as an abscess or a neoplasm. Treatment with Ceftriaxone and Decadron was started and intracranial hypertension was controlled.
Methotrexate was injected on the occasion of the next puncture considering a possible leukemia infiltration. Flagellate forms of T. cruzi were observed in the CSF and treatment with Benznidazole was started. After 4 days the CSF presented fractionated forms of trypomastigotes. The protein level was 27%. Signs of intracranial hypertension ceased. Tomography and magnetic resonance images showed an important reduction of the tumor-like lesion. The clinical condition of the patient improved.

Keywords: Chagas' disease; Leukemia; Tumor-like lesion.


RESUMO

Paciente masculino, 73 anos, do interior de Mato Grosso do Sul, com diagnóstico inicial de sinusite, evoluiu em 3 dias para quadro de hipertensão intracraniana severa.
Transferido para o serviço de neurologia, os exames evidenciaram leucemia linfocítica e indicaram ainda processo inflamatório expansivo como abscesso ou tumor (exame do líquor e tomografia). Instituiu-se Ceftriaxone e Decadron.
Foi feita nova punção lombar, injetou-se metotrexate considerando possível infiltração leucêmica.
No líquor observou-se formas flagelares de T. cruzi. Iniciou-se benzonidazol. Após 4 dias o líquor apresentou formas fracionadas de tripomastigotas. O nível de proteínas se estabilizou em 27%. Cessou a sintomatologia da hipertensão. Tomografia e ressonância magnética posterior mostraram importante redução da formação tumoral observada anteriormente. Houve melhora das condições clínicas do paciente.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

REFERENCES

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Correspondence to:
Dr. Eugênio O.M. de Barros
R. Quintino Bocaiúva, 298
79050-110 Campo Grande, Mato Grosso do Sul, Brasil

Recebido para publicação em 01/03/1996
Aceito para publicação em 11/07/1996

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