Reactivation of Chagas Disease in a Patient With an Autoimmune Rheumatic Disease: Case Report and Review of the Literature.

Autor: Czech MM; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA., Nayak AK; Department of Internal Medicine, Stanford University School of Medicine, Stanford, California, USA., Subramanian K; Department of Internal Medicine, Stanford University School of Medicine, Stanford, California, USA., Suarez JF; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA., Ferguson J; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA., Jacobson KB; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA., Montgomery SP; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Chang M; Harvard Medical School, Boston, Massachusetts, USA., Bae GH; Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA., Raghavan SS; Department of Pathology, Stanford University School of Medicine, Stanford, California, USA., Wang H; Department of Pathology, Stanford University School of Medicine, Stanford, California, USA., Miranti E; Department of Internal Medicine, Stanford University School of Medicine, Stanford, California, USA., Budvytiene I; Clinical Microbiology Laboratory, Stanford Health Care, Stanford, California, USA., Shoor SM; Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA., Banaei N; Clinical Microbiology Laboratory, Stanford Health Care, Stanford, California, USA., Rieger K; Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA.; Department of Pathology, Stanford University School of Medicine, Stanford, California, USA., Deresinski S; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA., Holubar M; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA., Blackburn BG; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2021 Feb 05; Vol. 8 (2), pp. ofaa642. Date of Electronic Publication: 2021 Feb 05 (Print Publication: 2021).
DOI: 10.1093/ofid/ofaa642
Abstrakt: Reactivation of Chagas disease has been described in immunosuppressed patients, but there is a paucity of literature describing reactivation in patients on immunosuppressive therapies for the treatment of autoimmune rheumatic diseases. We describe a case of Chagas disease reactivation in a woman taking azathioprine and prednisone for limited cutaneous systemic sclerosis (lcSSc). Reactivation manifested as indurated and erythematous cutaneous nodules. Sequencing of a skin biopsy specimen confirmed the diagnosis of Chagas disease. She was treated with benznidazole with clinical improvement in the cutaneous lesions. However, her clinical course was complicated and included disseminated CMV disease and subsequent septic shock due to bacteremia. Our case and review of the literature highlight that screening for Chagas disease should be strongly considered for patients who will undergo immunosuppression for treatment of autoimmune disease if epidemiologically indicated.
(© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje