Affordable Access

Publisher Website

Outcomes of patients in Chagas disease of the central nervous system: a systematic review.

Authors
  • Shelton, William J1
  • Gonzalez, John M1
  • 1 Grupo de Ciencias Básicas Medicas, School of Medicine, Universidad de Los Andes, Bogotá, Colombia. , (Colombia)
Type
Published Article
Journal
Parasitology
Publication Date
Jan 01, 2024
Volume
151
Issue
1
Pages
15–23
Identifiers
DOI: 10.1017/S0031182023001117
PMID: 37987164
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Chagas disease is a parasitic infection caused by the protozoan Trypanosoma cruzi. One of the complications of the disease is the infection of the central nervous system (CNS), as it can result from either the acute phase or by reactivation during the chronic phase, exhibiting high mortality in immunocompromised patients. This systematic review aimed to determine clinical and paraclinical characteristics of patients with Chagas disease in the CNS. Articles were searched from PubMed, Scopus and LILACS until January 2023. From 2325 articles, 59 case reports and 13 case series of patients with Chagas in the CNS were retrieved from which 138 patients were identified. In this population, 77% of the patients were male, with a median age of 35 years old, from which most of them came from Argentina and Brazil. Most of the individuals were immunocompromised from which 89% were HIV-positive, and 54 patients had an average of 48 cells per mm3 CD4+ T cells. Motor deficits and seizures were the most common manifestation of CNS compromise. Furthermore, 90 patients had a documented CNS lesion by imaging from which 89% were supratentorial and 86% were in the anterior/middle cranial fossa. The overall mortality was of 74%. Among patients who were empirically treated with anti-toxoplasma drugs, 70% died. This review shows how Chagas disease in the CNS is a devastating complication requiring prompt diagnosis and treatment to improve patients’ outcomes.

Report this publication

Statistics

Seen <100 times