Notice: Users may be experiencing issues with displaying some pages on stanfordhealthcare.org. We are working closely with our technical teams to resolve the issue as quickly as possible. Thank you for your patience.
 

Learn about the flu shot, COVID-19 vaccine, and our masking policy »

Stanford Health Care

Reactivation of Chagas Disease in a Patient With an Autoimmune Rheumatic Disease: Case Report and Review of the Literature. Open forum infectious diseases Czech, M. M., Nayak, A. K., Subramanian, K. n., Suarez, J. F., Ferguson, J. n., Jacobson, K. B., Montgomery, S. P., Chang, M. n., Bae, G. H., Raghavan, S. S., Wang, H. n., Miranti, E. n., Budvytiene, I. n., Shoor, S. M., Banaei, N. n., Rieger, K. n., Deresinski, S. n., Holubar, M. n., Blackburn, B. G. 2021; 8 (2): ofaa642

Abstract

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.

View details for DOI 10.1093/ofid/ofaa642

View details for PubMedID 33575423

View details for PubMedCentralID PMC7863873