Cases reported "Chagas Disease"

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1/18. Chagasic meningoencephalitis in a patient with acquired immunodeficiency syndrome: diagnosis, follow-up, and genetic characterization of trypanosoma cruzi.

    early diagnosis of the clinical reactivation of Chagas' disease in human immunodeficiency virus- and trypanosoma cruzi-coinfected persons is fundamental for a good prognosis. polymerase chain reaction rapidly and efficiently demonstrated the presence and elimination of T. cruzi in the cerebrospinal fluid of a patient with chagasic meningoencephalitis. Characterization of T. cruzi, directly and indirectly in blood and cerebrospinal fluid samples, demonstrated homogeneity of kinetoplast dna and the presence of lineage 1 (T. cruzi II) in both parasite populations.
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ranking = 1
keywords = meningoencephalitis, encephalitis
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2/18. Exacerbation of hiv viral load simultaneous with asymptomatic reactivation of chronic Chagas' disease.

    Chronic trypanosoma cruzi infection can reactivate in patients with immunosuppression related to human immunodeficiency virus (hiv) infection, resulting in severe meningoencephalitis or myocarditis and high parasitemia. The effects of T. cruzi on hiv infection are unknown. We describe an hiv-infected patient with chronic Chagas' disease who experienced an asymptomatic T. cruzi reactivation characterized by the finding of the parasite in direct microscopic examination of blood. The patient's hiv viral load had increased simultaneously with the exacerbation of T. cruzi parasitemia and decreased to previous levels after successful antiparasitic treatment. This otherwise unexplained finding suggests that T. cruzi infection might up-regulate hiv replication, which may affect hiv disease progression. Asymptomatic reactivation of Chagas' disease has not been reported before. This could mean that the severe clinical manifestations related to the reactivation of trypanosomiasis are just the tip of the iceberg.
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ranking = 0.2
keywords = meningoencephalitis, encephalitis
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3/18. Reactivation of Chagas' disease leading to the diagnosis of acquired immunodeficiency syndrome.

    Reactivation of chronic Chagas' disease is a rare condition and occurs only in immunosuppressed patients. We report a case of a patient with a rapid and fatal reactivation of Chagas' disease, manifested by meningoencephalitis, which lead to a diagnosis of acquired immunodeficiency syndrome (AIDS). We believe there is sufficient evidence to include the reactivation of Chagas' disease among the diagnostic criteria of AIDS in Human Immunodeficiency Virus (hiv) infection.
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ranking = 0.2
keywords = meningoencephalitis, encephalitis
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4/18. prenatal diagnosis of congenital Chagas' disease (American trypanosomiasis).

    The prenatal diagnosis of congenital transmission of Chagas' disease in a pregnant woman with the indeterminate form of the disease is reported. Sonography revealed fetal hydrops at 31 weeks' gestation. Anti-trypanosoma cruzi IgM and IgG antibodies were negative in the fetal blood sampled by cordocentesis, but T. cruzi trypomastigotes were found in its buffy coat. Owing to anemia, in utero exchange transfusion was undertaken, but fetal demise ensued. Labor was induced and a stillborn infant weighing 2030 g was delivered. The pathological examination revealed placentitis and meningoencephalitis, myocarditis and splenitis in the stillborn fetus. Amastigotes were found in the myocardium, brain and placenta.
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ranking = 0.2
keywords = meningoencephalitis, encephalitis
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5/18. Chagasic meningoencephalitis: case report of a recently included AIDS-defining illness in brazil.

    Recently, reactivation of chagas disease (meningoencephalitis and/or myocarditis) was included in the list of AIDS-defining illnesses in brazil. We report a case of a 52-year-old patient with no history of previous disease who presented acute meningoencephalitis. Direct examination of blood and cerebrospinal fluid (CSF) showed trypanosoma cruzi. CSF culture confirmed the diagnosis. Serological assays for T. cruzi and human immunodeficiency virus (hiv) were positive. Despite treatment with benznidazol and supportive measures, the patient died 24 hours after hospital admission. In endemic areas, reactivation of chagas disease should always be considered in the differential diagnosis of meningoencephalitis among hiv-infected patients, and its presence is indicative of AIDS.
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ranking = 1.4
keywords = meningoencephalitis, encephalitis
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6/18. Acute Chagas' disease (trypanosomiasis americana) in acquired immunodeficiency syndrome: report of two cases.

    Two heterosexual men, aged 31 and 40 years, with the acquired immunodeficiency syndrome and presenting with the acute form of Chagas' disease are reported. The first patient, a carrier of hemophilia a, was treated for 20 years with Chilean and Brazilian cryoprecipitates. This patient acquired both diseases through this medium. The second patient, an inhabitant of northern chile (fourth region), was allegedly bitten by triatoma infestans and was an intravenous drug addict. The hemophilic patient presented with a neurologic syndrome; a brain biopsy showed a necrotizing encephalitis with an obliterative angiitis and abundant macrophages. The second patient developed intractable congestive heart failure; necropsy showed a dilated myocarditis with rupture of myofibers and an inflammatory infiltrate rich in plasma cells, lymphocytes, and macrophages. Using light and electron microscopy, abundant amastigotes of trypanosoma cruzi were seen in brain tissue, especially in the cytoplasm of macrophages, as well as in some myocardial fibers. In both cases, determination of anti-T cruzi antibodies (indirect hemagglutination technique) and xenodiagnosis were positive.
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ranking = 0.013771621702613
keywords = encephalitis
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7/18. Fatal meningoencephalitis caused by reactivation of trypanosoma cruzi infection in a patient with AIDS.

    We report a case of fatal chagasic meningoencephalitis in an AIDS patient. Acute exacerbation of chronic Chagas' disease with involvement of the CNS is uncommon and occurs only in immunocompromised patients. This is the third such reported reactivation and it underscores the importance of considering Chagas' disease in hiv-positive patients from endemic regions.
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ranking = 1
keywords = meningoencephalitis, encephalitis
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8/18. Molecular diagnosis and typing of trypanosoma cruzi populations and lineages in cerebral chagas disease in a patient with AIDS.

    trypanosoma cruzi dna was amplified from an intracranial biopsy and peripheral blood of an hiv patient with encephalitis; this episode was indicative of AIDS and congenital chagas disease. The analysis of a micro-satellite locus revealed a multiclonal parasite population at the brain lesion with a more complex minicircle signature than that profiled in blood using restriction fragment length polymorphism (RFLP)-PCR and low stringency single primer (LSSP) PCR. Interestingly, different sublineages of T. cruzi II were detected in blood and brain by means of spliced-leader and 24salpha ribosomal-dna amplifications. Quantitative-competitive PCR monitored the decrease of parasitic load during treatment and secondary prophylaxis with benznidazole. The synergy between parasiticidal plus anti-retroviral treatments probably allowed the patient a longer survival than usually achieved in similar episodes. This is the first case report demonstrating a differential distribution of natural parasite populations and sublineages in chagas disease reactivation, showing the proliferation of cerebral variants not detectable in peripheral blood.
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ranking = 0.013771621702613
keywords = encephalitis
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9/18. Prolonged survival and immune reconstitution after chagasic meningoencephalitis in a patient with acquired immunodeficiency syndrome.

    We report a case of cerebral meningoencephalitis due to trypanosoma cruzi in a patient with acquired immunodeficiency syndrome. The patient presented with seizures and focal neurological signs. Definitive diagnosis of chagasic meningoencephalitis was made by demonstration of free trypomastigote forms in the cerebrospinal fluid. Benznidazol was prescribed with clinical and neurological improvement. Antiretroviral drugs improved cellular immunity and three years later the patient presents a good clinical condition with immune reconstitution and undetectable viral load. Chagasic meningoencephalitis has a poor prognosis when specific treatment is not initiated or is delayed. A high index of diagnosis is necessary for early diagnosis and treatment, especially in endemic areas for trypanosoma cruzi infection.
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ranking = 1.4
keywords = meningoencephalitis, encephalitis
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10/18. Acute fatal trypanosoma cruzi meningoencephalitis in a human immunodeficiency virus-positive hemophiliac patient.

    A 37-year-old hemophiliac patient with known, asymptomatic human immunodeficiency virus infection and chronic Chagas' disease was admitted to the hospital complaining of fever and headache. A computed tomographic scan revealed multiple ring-enhancing lesions in both cerebral hemispheres. No antibodies to trypanosoma cruzi were found in the cerebrospinal fluid. Treatment for toxoplasmosis of the central nervous system, which was considered the most likely diagnosis, was instituted, but the patient died after progressive neurologic deterioration. An autopsy revealed severe meningoencephalitis caused by T. cruzi.
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ranking = 1
keywords = meningoencephalitis, encephalitis
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