Volume 26, Number 8—August 2020
Dispatch
Plasma-Derived Extracellular Vesicles as Potential Biomarkers in Heart Transplant Patient with Chronic Chagas Disease
Table 1
Timeline of heart transplant patient with chronic Chagas disease from initial diagnosis to last follow-up and death*
Date | Infection | Observation, treatment, outcome |
---|---|---|
2015 Aug | Cytomegalovirus, detected by serology | Diagnosed only by positive IgG serology, no active infection (no positive IgM serology). No treatment. |
2015 Aug | Toxoplasmosis, detected by serology | Diagnosed only by positive IgG serology, no active infection (no positive IgM serology). No treatment. |
2015 Nov | Heart transplantation on Nov. 28. Patient started with immunosuppressive therapy (tacrolimus, azathioprine, prednisone) until the end of follow-up. | |
2016 Jan | Chagas disease reactivation, detection by qPCR | Pretreatment sample collected on Jan 28. Patient started BZN treatment (2.5 mg/kg, twice a day, 60 d) on Feb 3. |
2016 Mar | Bronchopulmonary aspergillosis, detected by serology and CT | BZN course interrupted on Mar 21. Completed 80% of the prescribed treatment. |
2016 Mar | Bronchopulmonary aspergillosis | Aspergillosis treatment started on Mar 22. Initially with voriconazole and amphotericin B liposomal. Treatment was changed to posaconazole until the end of the follow-up.† |
2016 Apr | Chagas disease reactivation, detected by qPCR | On Apr 14, patient started second round of BZN treatment until May 5, completing 100% of the prescribed treatment. |
2016 May | Posttreatment sample collected on May 11. | |
2016 Aug | Late organ rejection. Patient died. |
*BZN, benznidazole; CT, computed tomographic scan; qPCR, quantitative PCR.
†Parasite clearance could be related to the prolonged used of posaconazole, as previously reported (6), and/or the combined use of posaconazole and benznidazole because a second round of the latter was started in April 2016.
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1Current affiliation: CIBER Epidemiología y Salud Pública (CIBERESP); Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
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Page updated: July 18, 2020
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