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Cerebral tumor‐like American trypanosomiasis in acquired immunodeficiency syndrome
Author(s) -
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.
Publication year - 1999
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/1531-8249(199903)45:3<403::aid-ana20>3.0.co;2-k
Subject(s) - medicine , chagas disease , serology , differential diagnosis , trypanosomiasis , complication , pathology , immunodeficiency syndrome , cerebrospinal fluid , viral disease , immunodeficiency , immunopathology , disease , immunology , human immunodeficiency virus (hiv) , antibody , immune system
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