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World Neurosurg. 2019 Jun 6. pii: S1878-8750(19)31537-2. doi: 10.1016/j.wneu.2019.05.260. [Epub ahead of print]

Cerebral trypanosomiasis in an immunocompromised patient: case report and review of the literature.

Author information

1
Department of Neurosurgery, Medical College of Wisconsin 9200 W. Wisconsin Avenue, Milwaukee, WI 53226.
2
Department of Pathology, Medical College of Wisconsin 9200 W. Wisconsin Avenue, Milwaukee, WI 53226.
3
Department of Neurosurgery, Medical College of Wisconsin 9200 W. Wisconsin Avenue, Milwaukee, WI 53226. Electronic address: nzwagerman@mcw.edu.

Abstract

We document a case of central nervous system infection with Trypanosoma cruzi in an 88-year-old woman, who presented altered mental status, right sided weakness, and slurred speech. Past medical history was significant for methotrexate intake for rheumatoid arthritis, and she was tested negative for human immunodeficiency virus. She underwent MRI of the brain, which showed bilateral thick and peripherally enhancing white matter lesions in the frontoparietal region with extensive surrounding vasogenic edema. Lumbar puncture was done, which showed increase in protein and lymphocytic pleocytosis while 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.

KEYWORDS:

Chagas disease; Trypanosomiasis cruzi; benznidazole; kinetoplasts

PMID:
31176839
DOI:
10.1016/j.wneu.2019.05.260

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