Cohen JE, Tsai EC, Ginsberg HJ, Godes J
Pseudotumoral chagasic meningoencephalitis as the first manifestation of acquired immunodeficiency syndrome. [Case Reports, Journal Article]
Surg Neurol 1998 Mar; 49(3):324-7.
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.
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