{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:32:20Z","timestamp":1784194340965,"version":"3.55.0"},"reference-count":17,"publisher":"Instituto Nacional de Salud (Colombia)","issue":"2","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["revistabiomedica.org"],"crossmark-restriction":false},"short-container-title":["biomedica"],"abstract":"<jats:p>Introducci\u00f3n. La enfermedad de Chagas es una parasitosis end\u00e9mica en Latinoam\u00e9rica transmitida por triatominos. Est\u00e1 asociada a factores de riesgo como la pobreza y la ruralidad. Despu\u00e9s de la infecci\u00f3n aguda, un tercio de los pacientes presenta compromiso del coraz\u00f3n, el aparato digestivo o el sistema nervioso central, en tanto que los dos tercios restantes no presentan este tipo de compromiso secundario. La inmunosupresi\u00f3n farmacol\u00f3gica rompe el equilibrio entre el sistema inmunitario y el par\u00e1sito, lo cual favorece su reactivaci\u00f3n.Caso cl\u00ednico. Se presenta el caso de un hombre de 58 a\u00f1os procedente de un \u00e1rea rural colombiana, con diagn\u00f3stico de mieloma m\u00faltiple resistente a los f\u00e1rmacos de primera l\u00ednea de tratamiento, que requiri\u00f3 un nuevo esquema de quimioterapia y consolidaci\u00f3n con trasplante aut\u00f3logo de c\u00e9lulas madre.Despu\u00e9s del trasplante, present\u00f3 neutropenia febril. Los estudios microbiol\u00f3gicos iniciales fueron negativos. En el frotis de sangre perif\u00e9rica, se demostraron tripomastigotes y se diagnostic\u00f3 enfermedad de Chagas aguda posterior al trasplante. Se inici\u00f3 el tratamiento con benznidazol. La evoluci\u00f3n del paciente fue satisfactoria.Conclusiones. La serolog\u00eda positiva para Chagas previa a un trasplante obliga a descartar la reactivaci\u00f3n de la enfermedad en caso de neutropenia febril. Se requieren m\u00e1s estudios para determinar las herramientas que permitan estimar la probabilidad de reactivaci\u00f3n de la enfermedad y decidir sobre la mejor opci\u00f3n de relaci\u00f3n entre costo, riesgo y beneficio de la terapia profil\u00e1ctica.<\/jats:p>","DOI":"10.7705\/biomedica.6288","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T17:01:11Z","timestamp":1657731671000},"page":"224-233","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":5,"title":["Reactivaci\u00f3n de la enfermedad de Chagas despu\u00e9s de trasplante aut\u00f3logo de progenitores hematopoy\u00e9ticos. Reporte de caso y revisi\u00f3n de la literatura"],"prefix":"10.7705","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2694-2712","authenticated-orcid":false,"given":"Juan David","family":"Rojas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1539-1748","authenticated-orcid":false,"given":"Mario","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8985-8462","authenticated-orcid":false,"given":"Bibiana","family":"Mart\u00ednez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5841-1409","authenticated-orcid":false,"given":"Julio C\u00e9sar","family":"G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5676-880X","authenticated-orcid":false,"given":"Sonia Isabel","family":"Cuervo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4444","published-online":{"date-parts":[[2022,6,1]]},"reference":[{"key":"108830","doi-asserted-by":"crossref","unstructured":"Rueda K, Trujillo JE, Carranza JC, Vallejo GA. Transmisi\u00f3n oral de Trypanosoma cruzi: una nueva situaci\u00f3n epidemiol\u00f3gica de la enfermedad de Chagas en Colombia y otros pa\u00edses suramericanos. Biom\u00e9dica. 2014;34:631-72. https:\/\/doi.org\/10.7705\/biomedica.v34i4.2204","DOI":"10.7705\/biomedica.v34i4.2204"},{"key":"108831","unstructured":"World Health Organization. Chagas disease in Latin America: An epidemiological update based on 2010 estimates. Fecha de consulta: 5 de julio de 2021. Disponible en: https:\/\/www.who.int\/wer\/2015\/wer9006.pdf?ua=1"},{"key":"108832","doi-asserted-by":"crossref","unstructured":"Pereiro AC. Guidelines for the diagnosis and treatment of Chagas disease. Lancet. 2019;393:1486-7. https:\/\/doi.org\/10.1016\/S0140-6736(19)30288-0","DOI":"10.1016\/S0140-6736(19)30288-0"},{"key":"108833","doi-asserted-by":"crossref","unstructured":"Pierrotti LC, Carvalho NB, Amorin JP, Pascual J, Kotton CN, L\u00f3pez-V\u00e9lez R. Chagas disease recommendations for solid-organ transplant recipients and donors. Transplantation 2018;102:S1-7. https:\/\/doi.org\/10.1097\/TP.0000000000002019","DOI":"10.1097\/TP.0000000000002019"},{"key":"108834","doi-asserted-by":"crossref","unstructured":"Rajkumar SV. Multiple myeloma: 2020 update on diagnosis, risk-stratification and management. Am J Hematol 2020;95:548-67. https:\/\/doi.org\/10.1002\/ajh.25791","DOI":"10.1002\/ajh.25791"},{"key":"108835","doi-asserted-by":"crossref","unstructured":"Perrot A, Lauwers-Cances V, Cazaubiel T, Facon T, Caillot D, Clement-Filliatre L, et al. Early versus late autologous stem cell transplant in newly diagnosed multiple myeloma: Long-term follow-up analysis of the IFM 2009 Trial. Blood. 2020;136:39. https:\/\/doi.org\/10.1182\/blood-2020-134538","DOI":"10.1182\/blood-2020-134538"},{"key":"108836","doi-asserted-by":"crossref","unstructured":"P\u00e9rez CJ, Lymbery AJ, Thompson RCA. Reactivation of Chagas disease: Implications for global health. Trends Parasitol. 2015;31:595-603. https:\/\/doi.org\/10.1016\/j.pt.2015.06.006","DOI":"10.1016\/j.pt.2015.06.006"},{"key":"108837","doi-asserted-by":"crossref","unstructured":"Jarque I, Salavert M, Pem\u00e1n J. Parasitic infections in hematopoietic stem cell transplantation. Mediterr J Hematol Infect Dis. 2016;8:e2016035. https:\/\/doi.org\/10.4084\/MJHID.2016.035","DOI":"10.4084\/mjhid.2016.035"},{"key":"108838","doi-asserted-by":"crossref","unstructured":"Pinazo MJ, Espinosa G, Cort\u00e9s-Lletget C, Posada EJ, Aldasoro E, Oliveira I, et al. Immunosuppression and Chagas disease: A management challenge. PLoS Negl Trop Dis 2013;7;e1965. https:\/\/doi.org\/10.1371\/journal.pntd.0001965","DOI":"10.1371\/journal.pntd.0001965"},{"key":"108839","doi-asserted-by":"crossref","unstructured":"Riganti J, Maqueda MG, Pi\u00f1ero MCB, Volonteri VI, Galimberti RL. Reactivation of Chagas\u2019 disease: Cutaneous manifestations in two immunosuppressed patients. Int J Dermatol. 2012;51:829-34. https:\/\/doi.org\/10.1111\/j.1365-4632.2011.05224.x","DOI":"10.1111\/j.1365-4632.2011.05224.x"},{"key":"108840","unstructured":"Pan American Health Organization. Guidelines for the diagnosis and treatment of Chagas disease. Fecha de consulta: 5 de julio de 2021. Disponible en: https:\/\/iris.paho.org\/bitstream\/handle\/10665.2\/49653\/9789275120439_eng.pdf"},{"key":"108841","doi-asserted-by":"crossref","unstructured":"Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J, et al. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: A global perspective. 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Chagasic encephalitis in HIV patients: Common presentation of an evolving epidemiological and clinical association. 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