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获得性免疫缺陷综合征患者患恰加斯病性脑膜脑炎后的长期生存及免疫重建

Prolonged survival and immune reconstitution after chagasic meningoencephalitis in a patient with acquired immunodeficiency syndrome.

作者信息

Corti Marcelo, Yampolsky Claudio

机构信息

Division of HIV/AIDS Disease, F.J. Muñiz Infectious Diseases Hospital, Buenos Aires, Argentina.

出版信息

Rev Soc Bras Med Trop. 2006 Jan-Feb;39(1):85-8. doi: 10.1590/s0037-86822006000100018. Epub 2006 Feb 23.

Abstract

We report a case of cerebral meningoencephalitis due to Trypanosoma cruzi in a patient with acquired immunodeficiency syndrome. The patient presented with seizures and focal neurological signs. Definitive diagnosis of chagasic meningoencephalitis was made by demonstration of free trypomastigote forms in the cerebrospinal fluid. Benznidazol was prescribed with clinical and neurological improvement. Antiretroviral drugs improved cellular immunity and three years later the patient presents a good clinical condition with immune reconstitution and undetectable viral load. Chagasic meningoencephalitis has a poor prognosis when specific treatment is not initiated or is delayed. A high index of diagnosis is necessary for early diagnosis and treatment, especially in endemic areas for Trypanosoma cruzi infection.

摘要

我们报告一例因克氏锥虫引起的脑脑膜脑炎,患者患有获得性免疫缺陷综合征。该患者出现癫痫发作和局灶性神经体征。通过在脑脊液中发现游离的锥鞭毛体形式确诊为恰加斯病性脑膜脑炎。给予苯硝唑治疗后临床和神经症状有所改善。抗逆转录病毒药物改善了细胞免疫,三年后患者临床状况良好,免疫重建,病毒载量检测不到。如果不开始或延迟进行特异性治疗,恰加斯病性脑膜脑炎预后较差。对于早期诊断和治疗,尤其是在克氏锥虫感染的流行地区,需要有较高的诊断指数。

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