Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Dermatologia, São Paulo, SP, Brasil.
University of Texas Health Science Center, Department of Dermatology. Houston, Texas, United States of America.
Rev Soc Bras Med Trop. 2021 Mar 22;54:e0269-2020. doi: 10.1590/0037-8682-0269-2020. eCollection 2021.
Reactivation of chronic Trypanosoma cruzi infection in solid organ transplant recipients (SOTRs) has been reported. The patient presented with a 2-week history of two painful erythematous, infiltrated plaques with central ulceration and necrotic crust on the left thigh. She had a history of chronic indeterminate Chagas disease (CD) and had received a kidney transplant before 2 months. Skin biopsies revealed lobular panniculitis with intracellular amastigote forms of T. cruzi. The patient was diagnosed with CD reactivation. Treatment with benznidazole significantly improved her condition. CD reactivation should be suspected in SOTRs living in endemic areas with clinical polymorphism of skin lesions.
慢性克氏锥虫感染在实体器官移植受者(SOTR)中的再激活已被报道。该患者出现了 2 周的病史,表现为左大腿上有两个疼痛的红斑、浸润性斑块,中央有溃疡和坏死性结痂。她有慢性不定型恰加斯病(CD)病史,并在 2 个月前接受了肾移植。皮肤活检显示小叶性脂肪炎,有克氏锥虫的内阿米巴样形式。患者被诊断为 CD 再激活。用苯硝唑治疗显著改善了她的病情。生活在流行地区且皮肤病变表现多样的 SOTR 应怀疑 CD 再激活。