Case Report: Reactivation of Chagas disease in a patient with advanced HIV 15 Years after migration
Chagas disease is a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi. Chagas disease reactivation is an opportunistic infection in HIV-positive patients that commonly presents as meningoencephalitis and/or central nervous system abscesses. We describe the first known Iri...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Tropical Diseases |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fitd.2025.1588423/full |
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| author | Laura O’Doherty Annmarie White Ali Almajrafi Alain Fennessy Arlene Heekin Peter Bede Peter Bede Brendan Crowley Laura Nabarro Debbie Nolder Claire Rogers Catherine Moran Alan Beausang Sean Keane Sean Keane Michell Cruz Emma Devitt Emma Devitt Colm Bergin Colm Bergin |
| author_facet | Laura O’Doherty Annmarie White Ali Almajrafi Alain Fennessy Arlene Heekin Peter Bede Peter Bede Brendan Crowley Laura Nabarro Debbie Nolder Claire Rogers Catherine Moran Alan Beausang Sean Keane Sean Keane Michell Cruz Emma Devitt Emma Devitt Colm Bergin Colm Bergin |
| author_sort | Laura O’Doherty |
| collection | DOAJ |
| description | Chagas disease is a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi. Chagas disease reactivation is an opportunistic infection in HIV-positive patients that commonly presents as meningoencephalitis and/or central nervous system abscesses. We describe the first known Irish case of reactivation disease in a young patient from a Chagas-endemic region with previously undiagnosed HIV and profound immunocompromise. More than 15 years after migrating, he presented to the hospital with a headache, fever, and reduced consciousness. A diagnosis of Chagas disease reactivation was made with neuroimaging, epidemiological history, Chagas serology, and a brain biopsy. Despite the commencement of anti-parasitic therapy followed by anti-retroviral therapy (ART), he deteriorated and died 1 month after admission. There is no international consensus on the dosing of antiparasitic treatment or the timing of ART initiation in reactivation disease with T. cruzi in people living with HIV. This case highlights the need for further research into the management of this complex and highly morbid illness. |
| format | Article |
| id | doaj-art-4dbcabcb28fc41bb88fccb8d898b99ac |
| institution | OA Journals |
| issn | 2673-7515 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Tropical Diseases |
| spelling | doaj-art-4dbcabcb28fc41bb88fccb8d898b99ac2025-08-20T01:55:31ZengFrontiers Media S.A.Frontiers in Tropical Diseases2673-75152025-05-01610.3389/fitd.2025.15884231588423Case Report: Reactivation of Chagas disease in a patient with advanced HIV 15 Years after migrationLaura O’Doherty0Annmarie White1Ali Almajrafi2Alain Fennessy3Arlene Heekin4Peter Bede5Peter Bede6Brendan Crowley7Laura Nabarro8Debbie Nolder9Claire Rogers10Catherine Moran11Alan Beausang12Sean Keane13Sean Keane14Michell Cruz15Emma Devitt16Emma Devitt17Colm Bergin18Colm Bergin19Department of Genitourinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, IrelandDepartment of Genitourinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, IrelandDepartment of Genitourinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, IrelandDepartment of Intensive Care Medicine, St James’s Hospital, Dublin, IrelandDepartment of Genitourinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, IrelandDepartment of Neurology, St James’s Hospital, Dublin, IrelandSchool of Medicine, Trinity College Dublin, Dublin, IrelandDepartment of Microbiology, St James’s Hospital, Dublin, IrelandDepartment of Parasitology, The Hospital for Tropical Diseases, University College London Hospitals National Health Service (NHS) Foundations Trust, London, United KingdomDiagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, London, United KingdomDiagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, London, United KingdomDepartment of Neurosurgery, Beaumont Hospital, Dublin, IrelandDepartment of Neurohistopathology, Beaumont Hospital, Dublin, IrelandDepartment of Intensive Care Medicine, St James’s Hospital, Dublin, IrelandSchool of Medicine, Trinity College Dublin, Dublin, IrelandDepartment of Genitourinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, IrelandDepartment of Genitourinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, IrelandSchool of Medicine, Trinity College Dublin, Dublin, IrelandDepartment of Genitourinary Medicine and Infectious Diseases, St James’s Hospital, Dublin, IrelandSchool of Medicine, Trinity College Dublin, Dublin, IrelandChagas disease is a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi. Chagas disease reactivation is an opportunistic infection in HIV-positive patients that commonly presents as meningoencephalitis and/or central nervous system abscesses. We describe the first known Irish case of reactivation disease in a young patient from a Chagas-endemic region with previously undiagnosed HIV and profound immunocompromise. More than 15 years after migrating, he presented to the hospital with a headache, fever, and reduced consciousness. A diagnosis of Chagas disease reactivation was made with neuroimaging, epidemiological history, Chagas serology, and a brain biopsy. Despite the commencement of anti-parasitic therapy followed by anti-retroviral therapy (ART), he deteriorated and died 1 month after admission. There is no international consensus on the dosing of antiparasitic treatment or the timing of ART initiation in reactivation disease with T. cruzi in people living with HIV. This case highlights the need for further research into the management of this complex and highly morbid illness.https://www.frontiersin.org/articles/10.3389/fitd.2025.1588423/fullChagas diseasehuman immunodeficiency virus (HIV)immunocompromiseTrypanosomiasis cruzichagoma |
| spellingShingle | Laura O’Doherty Annmarie White Ali Almajrafi Alain Fennessy Arlene Heekin Peter Bede Peter Bede Brendan Crowley Laura Nabarro Debbie Nolder Claire Rogers Catherine Moran Alan Beausang Sean Keane Sean Keane Michell Cruz Emma Devitt Emma Devitt Colm Bergin Colm Bergin Case Report: Reactivation of Chagas disease in a patient with advanced HIV 15 Years after migration Frontiers in Tropical Diseases Chagas disease human immunodeficiency virus (HIV) immunocompromise Trypanosomiasis cruzi chagoma |
| title | Case Report: Reactivation of Chagas disease in a patient with advanced HIV 15 Years after migration |
| title_full | Case Report: Reactivation of Chagas disease in a patient with advanced HIV 15 Years after migration |
| title_fullStr | Case Report: Reactivation of Chagas disease in a patient with advanced HIV 15 Years after migration |
| title_full_unstemmed | Case Report: Reactivation of Chagas disease in a patient with advanced HIV 15 Years after migration |
| title_short | Case Report: Reactivation of Chagas disease in a patient with advanced HIV 15 Years after migration |
| title_sort | case report reactivation of chagas disease in a patient with advanced hiv 15 years after migration |
| topic | Chagas disease human immunodeficiency virus (HIV) immunocompromise Trypanosomiasis cruzi chagoma |
| url | https://www.frontiersin.org/articles/10.3389/fitd.2025.1588423/full |
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