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Tumour-like chagasic encephalitis in AIDS patients

CORRESPONDENCE

Tumour-like chagasic encephalitis in AIDS patients

TO THE EDITOR

I am a reader of Arquivos de Neuro-Psiquiatria. I have a comment on the article 2008;66(4):881-884; Tumor-like Chagas encephalitis in AIDS patients, Sica, Gargiullo and Papayanis. I congratulate the authors on the abundance of their material. I would like that the photomicrograph of the parasitic nest (Figure 2) had been made in oil immersion, to demonstrate the blepharoplasts characteristic of amastigotes of Chagas disease.

L.C. Mattosinho França

São Paulo, Brazil

THE AUTHORS REPLY

We thank the comments of Dr. L.C. Mattosinho França. Unfortunately, we have not pictures showing the parasite by employing microscopical immersion techniques.

Within the material that we have collected and studied in the last years, encompassing 18 AIDS patients with tumour-like chagasic encephalitis, 8 of them had positive sera test for toxoplasmosis as well; however, in all of them appropriate treatment targeting the toxoplasma neither rendered positive results nor modified the cerebral images; furthermore, their clinical manifestations worsen during treatment. Therefore, in those circumstances we carried on serological tests and looked for trypamastigotes in their blood, spinal fluid when possible, and, when necessary, in cerebral tissues either by performing biopsy or by surgically removing the lesion. In every case we could find laboratory signs of the presence of the parasite which prompted us to start specific treatment.

Being these persons weak regarding their immunological system, it is possible to accept that they could house more than one opportunistic infection at the same time, as seems to be the case with toxoplasma and T. Cruzi co-infection in these patients, at least in regards to their serological tests.

R.E.P. Sica

G. Gargiullo

C. Papayanis

Buenos Aires, Argentina

Publication Dates

  • Publication in this collection
    05 June 2009
  • Date of issue
    June 2009
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