title: Cerebral trypanosomiasis in a renal transplant recipient.
abstract: Chagas disease is a lifelong, systemic, parasitic infection caused by the protozoan Trypanosoma cruzi. The main form of disease transmission is vector borne, but vertical transmission, such as by organ transplantation from a chronically infected donor, is also possible. The brain tumor-like form can occur years after infection and has been described in patients with acquired immunodeficiency syndrome, and in a very few cases in transplant recipients. We describe the case of a kidney transplant patient who was human immunodeficiency virus negative and infected with T. cruzi, and developed cerebral trypanosomiasis that was successfully treated with benznidazole at 7 mg/kg/day for 60 days. The risk of Chagas disease transmission should not be underestimated in renal transplant patients, even in non-endemic areas. Chagas disease can present as a tumor-like brain lesion, very difficult to differentiate from other opportunistic infectious or neoplastic processes. Frequent monitoring for T. cruzi infection is essential to promptly implement treatment, which, in our patient, proved to be effective and safe.
authors.affiliation: Renal Transplantation, Hospital de Alta Complejidad JD Perón, Formosa, Argentina; Foundation for Research and Assistance in Renal Disease (FINAER), Buenos Aires, Argentina.
authors.forename: F
authors.initials: F
authors.lastname: Cicora
authors.forename: V
authors.initials: V
authors.lastname: Escurra
authors.forename: J
authors.initials: J
authors.lastname: Bibolini
authors.forename: J
authors.initials: J
authors.lastname: Petroni
authors.forename: I
authors.initials: I
authors.lastname: González
authors.forename: J
authors.initials: J
authors.lastname: Roberti
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000469:parasitology*; D020808:Central Nervous System Protozoal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014355:Chagas Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009593:Nitroimidazoles / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014344:Trypanocidal Agents / Q000627:therapeutic use
chemical_list: D009593:Nitroimidazoles; D014344:Trypanocidal Agents; C009999:benzonidazole
keywords: Chagas disease; Trypanosoma cruzi; brain chagoma; kidney transplant; trypanosomiasis