Abstract
Chagas disease is an infection caused by Trypanosoma cruzi, a parasite endemic in Latin America. Acute involvement of the CNS by Chagas has been considered rare, but presumed reactivation of chronic disease in immunosuppressed patients has been the subject of recent reports. Our objective is to describe the clinical and imaging characteristics of four patients with Chagas disease and CNS involvement, and the patients had to have available MRI and a diagnosis confirmed by biopsy. The imaging findings were similar, highlighting the presence of focal cerebral lesions with hypointensity on T2-WI, and these lesions assume a “bunch of acai berries appearance”, a fruit involved in the transmission of T. cruzi. The post Gd T1-WI shows punctate enhancement. Knowledge of this pattern may be crucial to recognize this disease in immunocompromised patients from endemic areas.
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References
Gluckstein D, Ciferri F, Ruskin J (1992) Chagas’ disease: another cause of cerebral mass in the acquired immunodeficiency syndrome. Am J Med 92:429–432
Moncayo A, Silveira AC (2009) Current epidemiological trends for Chagas disease in Latin America and future challenges in epidemiology, surveillance and health policy. Mem Inst Oswaldo Cruz 104( Suppl 1): 17–30
Vasconcelos Miranda TA, Tsuchiya K, Lucato LT (2023) Imaging of central nervous system parasitic infections. Neuroimaging Clin N Am 33(1):125–146
Pittella JE (2009) Central nervous system involvement in Chagas disease: a hundred-year-old history. Trans R Soc Trop Med Hyg 103(10):973–978
Nóbrega AA, Garcia MH, Tatto E et al (2009) Oral transmission of Chagas disease by consumption of açaí palm fruit. Brazil Emerg Infect Dis 15(4):653–655
Dan LL (2015) Chagas’ disease. N Engl J Med 373:456–466
Dias JCP (1989) The indeterminate form of human chronic Chagas’ disease: a clinical epidemological review. Rev Soc Bras Med Trop 22(3):147–156
Taieb G, Duran-Peña A, de Chamfleur NM et al (2016) Punctate and curvilinear gadolinium enhancing lesions in the brain: a practical approach. Neuroradiology 58(3):221–235
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Fonseca, A.P.A., de Melo, R.F.Q., Menezes, T. et al. “Bunch of acai berries sign”: a new radiological sign in patients with CNS involvement in Chagas disease. Neuroradiology 65, 1665–1668 (2023). https://doi.org/10.1007/s00234-023-03181-2
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DOI: https://doi.org/10.1007/s00234-023-03181-2