Cerebral trypanosomiasis in an incarcerated man

American trypanosomiasis (Chagas disease) is a parasitosis endemic to South America that rarely occurs in the southern United States. Typanosoma cruzi, the causative flagellate protozoan, is transmitted to humans by various species of hematophagous triatomine insects and less frequently through bloo...

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Published inCanadian Medical Association journal (CMAJ) Vol. 176; no. 4; p. 448
Main Authors Nijjar, Satnam S, Del Bigio, Marc R
Format Journal Article
LanguageEnglish
Published Canada CMA Impact Inc 13.02.2007
CMA Impact, Inc
Canadian Medical Association
SeriesClinical Vistas
Subjects
Adult
Animals
Biopsy
Biopsy, Needle
Brain
Case studies
Central Nervous System Protozoal Infections - diagnosis
Central Nervous System Protozoal Infections - pathology
Central Nervous System Protozoal Infections - therapy
Chagas' disease
Craniotomy
Diagnosis
Disease Progression
Fatal Outcome
Humans
Immunohistochemistry
Male
Manitoba
Medical diagnosis
Medical treatment
Meningitis
Nitroimidazoles - therapeutic use
Practice
Prisoners
Tomography, X-Ray Computed
Trypanosoma - classification
Trypanosomiasis - diagnosis
Trypanosomiasis - therapy
Manitoba
Canada
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Summary:American trypanosomiasis (Chagas disease) is a parasitosis endemic to South America that rarely occurs in the southern United States. Typanosoma cruzi, the causative flagellate protozoan, is transmitted to humans by various species of hematophagous triatomine insects and less frequently through blood transfusion, congenital transmission, consumption of raw meat from an infected reservoir, accidental laboratory infection or organ transplants from an infected donor.1 In younger children, acute meningoencephalitis occurs rarely and is usually fatal. Similar to previous reports,2,3 our case is an example of the rare patient, particularly someone with a compromised immune system, who presents with an intracranial tumour-like lesion that has been called a "chagoma." It is peculiar that our patient was a native of Manitoba with no known travel history. We speculate that he may have shared an intravenous needle with an infected person or that he travelled without anyone's knowledge. His apparent immunocompromised state of unknown cause may have resulted in reactivation of T. cruzi.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.060540