Cerebral tumor-like American trypanosomiasis in acquired immunodeficiency syndrome

• Published in: Annals of neurology Vol. 45; no. 3; pp. 403 - 406
• Main Authors: Pagano, Miguel A., Segura, Martín J., Di Lorenzo, Guillermo A., Garau, María L., Molina, Hugo A., Cahn, Pedro, Perez, Héctor, Vítolo, Fabián, Grondona, Alba, Piedimonte, Fabián C., Giannaula, Rolando, Ramia, Raúl, Miranda, Miguel A., Sierra, Hernán, Sica, Roberto E. P.
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01-03-1999; Willey-Liss
• Subjects: Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - parasitology; Acquired Immunodeficiency Syndrome - pathology; Adult; AIDS/HIV; Biological and medical sciences; Cerebral Cortex - pathology; Female; Human protozoal diseases; Humans; Infectious diseases; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Parasitic diseases; Protozoal diseases; Tropical medicine; Trypanosomiasis; Trypanosomiasis - etiology; Trypanosomiasis - pathology; Human; Pseudotumor; Immunopathology; Intracranial; Protozoal disease; Nervous system diseases; Chagas disease; AIDS; Parasitosis; Immune deficiency; Differential diagnostic; Cerebral disorder; Infection; Case study; Viral disease; Central nervous system disease; Adult; Complication; Tumor; Trypanosomiasis
• ISSN: 0364-5134; 1531-8249
• DOI: 10.1002/1531-8249(199903)45:3<403::AID-ANA20>3.0.CO;2-K

Cerebral tumor‐like American trypanosomiasis (CTLAT) is an uncommon complication of Chagas' disease, observed only in immunosuppressed patients. We assessed 10 human immunodeficiency virus–positive patients with Chagas' disease who presented with CTLAT. All patients had neurological involvement and 6 developed intracranial hypertension. Neuroimaging studies showed supratentorial lesions in 9 patients, being single in 8. One case had infratentorial and supratentorial lesions. Low CD4+ cell counts were observed in all the cases and in 6 of them CTLAT was the first manifestation of acquired immunodeficiency syndrome. Serological tests for Chagas' disease were positive in 6 of 8 patients. Trypanosoma cruzi was identified in all brain specimens and in three cerebrospinal fluid samples. CTLAT should be considered in the differential diagnosis of intracranial mass lesions in human immunodeficiency virus–positive patients and should be added to the list of acquired immunodeficiency syndrome–defining illnesses. Ann Neurol 1999;45:403–406