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Reactivation of Chagas' disease in a human immunodeficiency virus-infected patient leading to severe heart disease with a late positive direct microscopic examination of the blood.
Sartori AM; Lopes MH; Benvenuti LA; Caramelli B; di Pietro A; Nunes EV;
February 28, 1999
Am J Trop Med Hyg. 1998 Nov;59(5):784-6. Unique Identifier : AIDSLINE

We report a human immunodeficiency virus (HIV)-infected man with chronic Chagas' disease who developed a congestive heart failure that could not be clinically controlled. Endomyocardial biopsy revealed severe myocarditis and the xenodiagnosis result was positive, but Trypanosoma cruzi by direct microscopic examination of the blood was found only four months after the symptoms had started. Treatment with benznidazole was effective in reducing parasitemia, stabilizing the clinical status, and controlling tissue damage related to the parasite. Although the finding of T. cruzi trypomastigotes by direct microscopic examination of the blood has been considered the mark of Chagas' reactivation in immunocompromised patients with chronic disease, in this case it was a late finding.

JOURNAL ARTICLE Adult Animal AIDS-Related Opportunistic Infections/*COMPLICATIONS Case Report Chagas Disease/*COMPLICATIONS/PARASITOLOGY Chronic Disease Heart Diseases/*COMPLICATIONS/PATHOLOGY/PARASITOLOGY Heart Failure, Congestive/COMPLICATIONS Human Immunocompromised Host Male Myocarditis/COMPLICATIONS/PATHOLOGY/PARASITOLOGY Recurrence Trypanosoma cruzi/ISOLATION & PURIF