Cerebral Trypanosomiasis in an Immunocompromised Patient: Case Report and Review of the Literature

Mayank Kaushal, S. Shabani, Elizabeth J. Cochran, H. Samra, Nathan T. Zwagerman

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)225-231
Number of pages7
JournalWorld Neurosurgery
Volume129
DOIs
StatePublished - Sep 2019
Externally publishedYes

Keywords

  • Benznidazole
  • Chagas disease
  • Kinetoplasts
  • Trypanosoma cruzi

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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