TY - JOUR
T1 - Cerebral Trypanosomiasis in an Immunocompromised Patient
T2 - Case Report and Review of the Literature
AU - Kaushal, Mayank
AU - Shabani, S.
AU - Cochran, Elizabeth J.
AU - Samra, H.
AU - Zwagerman, Nathan T.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/9
Y1 - 2019/9
N2 - 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.
AB - 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.
KW - Benznidazole
KW - Chagas disease
KW - Kinetoplasts
KW - Trypanosoma cruzi
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U2 - 10.1016/j.wneu.2019.05.260
DO - 10.1016/j.wneu.2019.05.260
M3 - Article
C2 - 31176839
AN - SCOPUS:85068268422
SN - 1878-8750
VL - 129
SP - 225
EP - 231
JO - World Neurosurgery
JF - World Neurosurgery
ER -