del Valle PUD, Trombetta DLA, Moreno RD, Galache VV, Semorile MK, Bava SAJ

Language: Spanish
References: 9
Page: 458-464
PDF size: 166.72 Kb.

ABSTRACT

Chagas disease, endemic in Argentina, goes through two stages: acute and chronic. In VIH seropositive patients, Trypanosoma cruzi affects those with severe immunodeficiency; it is mainly located in the central nervous system and less frequently in the myocardium. Distinction between acute myocarditis and chronic infection reactivation is not simple. Low T CD4+ lymphocyte count is a positive predictive factor of reactivation. In patients with advanced immunodeficiency, negative results of serological tests do not exclude diagnosis of Chagas disease which may bre confirmed through the application of direct methods in blood and cerebrospinal fluid. The case of a VIH infected patient who got the disease through vertical transmission with severe immunodeficiency, acute myocarditis and central nervous system damage. Positive parasitemia and parasitorrachya for T. cruzi established the association between these symptoms and Chagas disease.

REFERENCES

1. Corti M, Trione N, Corbera K, Vivas C. Enfermedad de Chagas: otra causa de masa cerebral ocupante en pacientes con síndrome de inmunodeficiencia adquirida. Enferm Infecc Microbiol Clin. 2000;18(4):194-5.

2. Corti M. AIDS and Chagas’ Disease. Review. AIDS Patient Care STDS. 2000;14(11):581-8.

3. Auger S, Storino R, De Rosa M, Caravello O, Gonzalez M, Botaro E, et al. Chagas y SIDA, la importancia del dignóstico precoz. Rev. Argent. Cardiol. [online]. 2005;73(6):439-445 [citado 2013-01-19]. Disponible en: . ISSN 1850-3748.

4. Vaidian AK, Weiss LM, Tanowitz HB. Chagas' disease and AIDS. Kinetoplastid Biol Dis. 2004;3(1):2.

5. Novaes Ramos Júnior A, Tatto E, Rocha A, Sartori A, Correia D, Dias Gontijo E, et al. Recomendações para diagnostico, tratamento, e acompanhamento da coinfecção Trypanosoma cruzi-vírus da imunodeficiência humana. Ministério da Saúde. Rev Soc Bras Med Trop. 2006;39(4):392-415.

6. Almeida EA, Silva EL, Guariento ME, Souza ML, Aoki FH, Pedro R de J. Evolução fatal da co-infecção doença de Chagas/Aids: dificuldades diagnósticas entre reagudização da miocardite e a miocardiopatia chagásica crônica. Rev Soc Bras Méd Trop. 2009;42(2):199-202.

7. Guías para la atención al paciente infectado con Trypanosoma cruzi (Enfermedad de Chagas). Buenos Aires: Ministerio de Salud de la Nación, 2012. [Internet] [citado 20 de julio de 2014]. Disponible en: http://www.msal.gov.ar/chagas/images/stories/Equipos/Guia_Nacional_Chagas_ve rsion_27092012.pdf

8. Sartori AM, Lopes MH, Caramelli B, Duarte MI, Pinto PL, Neto V, et al. Simultaneous occurrence of acute myocarditis and reactivated Chagas disease in a patient with AIDS. Clin Infect Dis. 1995;21:1297-1299.

9. De Almeida E, Novaes Ramos A, Correia D, Shikanai-Yasuda M. Co-infection Trypanosoma cruzi/HIV: systematic review (1980 - 2010). Rev Soc Bras Med Trop. 2011;44(6):762-770.