PSEUDOTUMORAL CHAGASIC MENINGOENCEPHALITIS AS THE FIRST MANIFESTATIONOF ACQUIRED-IMMUNODEFICIENCY-SYNDROME

BACKGROUND Patients with AIDS frequently show secondary involvement of the brain by different infectious agents, and Chagas' disease is now recognized as a potential opportunistic infection. To our knowledge, p seudotumoral chagasic meningoencephalitis has not been previously repo rted as the first manifestation of AIDS. METHODS AND RESULTS A 30-year -old Argentinian man without any risk factor for HIV infection was adm itted to the hospital with an acute onset of drowsiness. A computed to mography scan showed a hypodense parietal tumor-like lesion. Open brai n biopsy revealed hemorrhagic necrosis and numerous amastigotes of Try panosoma cruzi. Nifurtimox was started, but the patient died. CONCLUSI ONS Chagas' disease can reactivate in patients with AIDS and present a s a brain mass that is indistinguishable from other infectious or neop lasic processes. Our report demonstrates this entity as the first mani festation of AIDS. (C) 1998 by Elsevier Science Inc.