PDF(Pubmed)
Abstract：
Chagas disease is a parasitic infection caused by the protozoan Trypanosoma cruzi. One of the complications of the disease is the infection of the central nervous system (CNS), as it can result from either the acute phase or by reactivation during the chronic phase, exhibiting high mortality in immunocompromised patients. This systematic review aimed to determine clinical and paraclinical characteristics of patients with Chagas disease in the CNS. Articles were searched from PubMed, Scopus and LILACS until January 2023. From 2325 articles, 59 case reports and 13 case series of patients with Chagas in the CNS were retrieved from which 138 patients were identified. In this population, 77% of the patients were male, with a median age of 35 years old, from which most of them came from Argentina and Brazil. Most of the individuals were immunocompromised from which 89% were HIV-positive, and 54 patients had an average of 48 cells per mm3 CD4+ T cells. Motor deficits and seizures were the most common manifestation of CNS compromise. Furthermore, 90 patients had a documented CNS lesion by imaging from which 89% were supratentorial and 86% were in the anterior/middle cranial fossa. The overall mortality was of 74%. Among patients who were empirically treated with anti-toxoplasma drugs, 70% died. This review shows how Chagas disease in the CNS is a devastating complication requiring prompt diagnosis and treatment to improve patients’ outcomes.
摘要：
恰加斯病是由原生动物克氏锥虫引起的寄生虫感染。该疾病的并发症之一是中枢神经系统（CNS）的感染，因为它可能是由急性期或慢性期的重新激活引起的，在免疫功能低下的患者中表现出高死亡率。本系统综述旨在确定中枢神经系统查加斯病患者的临床和临床特征。文章从PubMed搜索，Scopus和LILACS直到2023年1月。从2325篇文章检索到59例病例报告和13例中枢神经系统Chagas患者的病例系列，从中确定了138例患者。在这个人群中,77%的患者为男性，平均年龄为35岁，其中大部分来自阿根廷和巴西。大多数人免疫受损，其中89%是艾滋病毒阳性，54例患者平均每mm3CD4+T细胞有48个细胞。运动缺陷和癫痫发作是中枢神经系统损害的最常见表现。此外，90例患者通过影像学检查证实有中枢神经系统病变，其中89％为幕上，86％位于前颅/中颅窝。总死亡率为74%。在接受抗弓形虫药物经验性治疗的患者中，70%的人死亡。这篇综述显示了中枢神经系统的查加斯病是一种破坏性的并发症，需要及时诊断和治疗以改善患者的预后。
