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Recurrent Chagas’ disease meningomyelitis in an HIV-infected patient
  1. Igor Melo de Almeida1,
  2. Aline Borges Moreira da Rocha2,
  3. José Angelo Lauletta Lindoso3,
  4. Vera Lúcia Teixeira de Freitas4,
  5. Augusto CP Oliveira5,
  6. Jose E Vidal6
  1. 1Neurology, Unifesp EPM, Sao Paulo, Brazil
  2. 2Department of Infectious Diseases, Instituto de Infectologia Emilio Ribas, Sao Paulo, Brazil
  3. 3Department of Laboratory, Instituto de Infectologia Emilio Ribas, Sao Paulo, Brazil
  4. 4Department of Infectious Diseases, Universidade de São Paulo, Sao Paulo, Brazil
  5. 5Instituto de Infectologia Emilio Ribas, Sao Paulo, Brazil
  6. 6Department of Neurology, Instituto de Infectologia Emilio Ribas, Sao Paulo, Brazil
  1. Correspondence to Dr Igor Melo de Almeida, Neurology, Unifesp EPM, Sao Paulo, Brazil; igorm.dml{at}gmail.com

Abstract

Chagas’ disease reactivation leading to monophasic acute or subacute meningoencephalitis or space-occupying lesions is a well-described AIDS-defining condition in Latin America. We report a 59-year-old man native from the Northeast region of Brazil, with a second episode of subacute chagasic meningomyelitis. He had long-term multidrug-resistant HIV and had abandoned combined antiretroviral therapy (CD4+ lymphocyte count, 16 cells/mm³, and HIV viral load 169 403 copies/mL). He initially received benznidazole but switched to nifurtimox after developing myelotoxicity. He was discharged home having made a partial neurological improvement. Chagas’ disease should be included in the differential diagnosis of meningomyelitis in people living with HIV/AIDS who are from endemic areas of this parasitic disease.

  • INFECTIOUS DISEASES
  • TROPICAL NEUROLOGY
  • CLINICAL NEUROLOGY
  • AIDS
  • MYELOPATHY

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Footnotes

  • Contributors 1 - Article project: A. Conception, B. Organisation, C. Execution, D. Supervision. 2 - Manuscript: A. Writing of the first draft; B. Review and Critique. IMdA: 1A, 1B, 1C, 2A, 2B (Nothing to disclose). ABMdR: 1A, 1B, 1C, 2A, 2B (Nothing to disclose). ACPO: 1A, 2B (Nothing to disclose). JALL: 1A, 2B (Nothing to disclose). VLTdF: 1A, 2B (Nothing to disclose). JEV: 1A, 2B, 1D (Nothing to disclose).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned. Externally peer reviewed by Jonathan Underwood, Cardiff, UK.