Central nervous system involvement caused by reactivation of Trypanosoma cruzi infection in a patient with HIV infection:

Abstract

Reactivation of Trypanosoma cruzi infection is an uncommon diagnosis but one that must be considered in immunocompromised patients with neurological clinical manifestations associated with expansive brain lesions. We present the case of a 56- year-old man, from an endemic area of Chagas disease in Chile, who presented with neurological symptoms and a brain lesion with a pseudotumoral appearance. The detection of an advanced HIV infection guided the search for opportunistic infections with central nervous system involvement. The diagnosis was confirmed through serology, PCR, and visualization of T. cruzi trypomastigotes in blood and cerebrospinal fluid (CSF). Despite treatment, the patient had an irreversible neurological sequelae and died from infectious complications. This case highlights the importance of considering this reactivation in immunocompromised patients with brain lesions, as timely diagnosis is key to improving outcomes.