{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:30:53Z","timestamp":1761823853426},"reference-count":13,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2,8]]},"abstract":"<jats:p>Central nervous system (CNS) involvement in Chagas disease (CD) is an uncommon complication that can result from direct involvement of the parasite or from thromboembolic phenomena. Direct involvement of CNS can occur in both acute and chronic forms of CD, and can also be secondary to reactivation. Reactivation of CD generally occurs in immunosuppressed patients such as those with human immunodeficiency infection or malignancies being rarely described in patients without apparent immunosuppression. We report a case of a patient living for many years in a nonendemic area for CD that presented to the emergency department with sudden onset of neurological symptoms as a result of reactivation of the disease. The microorganism was isolated from cerebrospinal fluid, and despite appropriate use of benznidazole, the patient died of sepsis after 22 days of treatment. Further investigation did not show any apparent cause of immunosuppression. This case report shows the importance of considering the diagnostic possibility of neurological complications from CD reactivation in patients that have ever lived in CD-endemic areas even without apparent underlying immunosuppression.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0225","type":"journal-article","created":{"date-parts":[[2016,12,20]],"date-time":"2016-12-20T02:45:46Z","timestamp":1482201946000},"page":"292-294","source":"Crossref","is-referenced-by-count":12,"title":["Meningoencephalitis Caused by Reactivation of Chagas Disease in Patient Without Known Immunosuppression"],"prefix":"10.4269","volume":"96","author":[{"given":"Herbert J.","family":"Fernandes","sequence":"first","affiliation":[{"name":"Hospital Eduardo de Menezes, Minas Gerais, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luanda O. F.","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Hospital da Baleia, Minas Gerais, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara S.","family":"Machado","sequence":"additional","affiliation":[{"name":"Hospital Eduardo de Menezes, Minas Gerais, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o Paulo R.","family":"Campos","sequence":"additional","affiliation":[{"name":"Hospital da Baleia, Minas Gerais, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre S.","family":"Moura","sequence":"additional","affiliation":[{"name":"Hospital Eduardo de Menezes, Minas Gerais, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"N Engl J Med","first-page":"456","article-title":"Chagas' disease","volume":"373","author":"Bern","year":"2015"},{"key":"ref2","series-title":"Brain Res Bull","first-page":"153","article-title":"Trypanosoma cruzi infection and the rat central nervous system: proliferation of parasites in astrocytes and the brain reaction to parasitism","volume":"53","author":"Da Mata","year":"2000"},{"key":"ref3","series-title":"Ann Neurol","first-page":"403","article-title":"Cerebral tumor-like American tryoanosomiasis in acquired immunodeficiency syndrome","volume":"45","author":"Pagano","year":"1999"},{"key":"ref4","series-title":"Arq Neuropsiquiatr","first-page":"102","article-title":"Trypanossoma cruzi meningoencephalitis in AIDS mimicking cerebral metastases","volume":"54","author":"Pimentel","year":"1996"},{"key":"ref5","series-title":"Neurol Res","first-page":"238","article-title":"Neurological manifestations of Chagas' disease","volume":"32","author":"Cordova","year":"2010"},{"key":"ref6","series-title":"Int J Infect Dis","first-page":"587","article-title":"Reactivation of Chagas disease with central nervous system involvement in HIV-infected patients in Argentina, 1992\u20132007","volume":"12","author":"Cordova","year":"2008"},{"key":"ref7","series-title":"Trans R Soc Trop Med Hyg","first-page":"973","article-title":"Central nervous system involvement in Chagas disease: a hundred-year-old history","volume":"103","author":"Pittella","year":"2009"},{"key":"ref8","series-title":"Mem Inst Oswaldo Cruz","first-page":"219","article-title":"Nova entidade m\u00f3rbida do homem: rezumo geral dos estudos etiol\u00f3gicos e cl\u00ednicos","volume":"3","author":"Chagas","year":"1911"},{"key":"ref9","series-title":"Lancet Infect Dis","first-page":"92","article-title":"Clinical and epidemiological aspects of Chagas disease","volume":"1","author":"Prata","year":"2001"},{"key":"ref10","series-title":"PLoS Negl Trop Dis","first-page":"e1965","article-title":"Immunosuppression and Chagas disease: a management challenge","volume":"7","author":"Pinazo","year":"2013"},{"key":"ref11","series-title":"Mem Inst Oswaldo Cruz","first-page":"443","article-title":"Some aspects of protozoan infections in immunocompromised patients\u2014a review","volume":"97","author":"Ferreira","year":"2002"},{"key":"ref12","series-title":"Arq Neuropsiquiatr","first-page":"881","article-title":"Tumor-like chagasic encephalitis in AIDS patients","volume":"66","author":"Sica","year":"2008"},{"key":"ref13","series-title":"Am J Trop Med Hyg","first-page":"294","article-title":"Case report: molecular identification of Trypanosoma cruzi I tropism for central nervous system in Chagas reactivation due to AIDS","volume":"78","author":"Burgos","year":"2008"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/96\/2\/article-p292.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/96\/2\/article-p292.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/96\/2\/article-p292.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T22:35:56Z","timestamp":1723070156000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/96\/2\/article-p292.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,8]]},"references-count":13,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.16-0225","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2017,2,8]]}}}