Trypanosoma cruzi Central Nervous System Infection—Pathogenesis, Clinical Manifestations, Diagnosis, and Treatment

Christian Olivo-Freites, Hendrik Sy, Jorge Cardenas-Alvarez, Franklyn Vega-Batista, Andrés F. Henao-Martínez

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Chagas disease (CD) is a neglected tropical disease from the American continent that commonly causes cardiovascular disease. Some patients develop neurological manifestations. We discuss and summarize the pathogenesis, clinical characteristics, diagnosis, and treatment of the central nervous system manifestations of CD. Recent Findings: Cerebrospinal fluid quantitative polymerase chain reaction tests and next-generation sequencing in tissue samples have facilitated disease diagnosis and follow-up. Novel presentations, including retinitis, are now reported. A new MRI sign called “Bunch of açai berries appearance”—multiple hypointense nodular lesions—has been described recently. Treatment with benznidazole at higher doses and the role of therapeutic drug monitoring need to be further studied in this setting. Summary: A high suspicion index is paramount to diagnosing Chagas’ central nervous system involvement. Standardized molecular diagnostics can aid in the initial workup. Future development of new therapeutic drugs is crucial because of the toxicity profile of the currently available medications.

Original languageEnglish
Pages (from-to)186-198
Number of pages13
JournalCurrent Tropical Medicine Reports
Volume10
Issue number4
DOIs
StatePublished - Dec 2023
Externally publishedYes

Keywords

  • American trypanosomiasis
  • CNS infection
  • Cerebral protozoal infections
  • Chagas disease
  • Meningitis
  • Trypanosoma cruzi

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