Pseudotumoral chagasic meningoencephalitis as the first manifestation of acquired immunodeficiency syndrome

Surg Neurol. 1998 Mar;49(3):324-7. doi: 10.1016/s0090-3019(97)00173-0.

Abstract

Background: Patients with AIDS frequently show secondary involvement of the brain by different infectious agents, and Chagas' disease is now recognized as a potential opportunistic infection. To our knowledge, pseudotumoral chagasic meningoencephalitis has not been previously reported as the first manifestation of AIDS.

Methods and results: A 30-year-old Argentinian man without any risk factor for HIV infection was admitted to the hospital with an acute onset of drowsiness. A computed tomography scan showed a hypodense parietal tumor-like lesion. Open brain biopsy revealed hemorrhagic necrosis and numerous amastigotes of Trypanosoma cruzi. Nifurtimox was started, but the patient died.

Conclusions: Chagas' disease can reactivate in patients with AIDS and present as a brain mass that is indistinguishable from other infectious or neoplasic processes. Our report demonstrates this entity as the first manifestation of AIDS.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • AIDS-Related Opportunistic Infections / diagnostic imaging
  • AIDS-Related Opportunistic Infections / parasitology*
  • Adult
  • Chagas Disease* / diagnostic imaging
  • Diagnosis, Differential
  • Humans
  • Male
  • Meningoencephalitis / diagnostic imaging
  • Meningoencephalitis / parasitology*
  • Tomography, X-Ray Computed