Fulminant and fatal Trypanosoma cruzi reactivation in a patient with lymphoma

November 17, 2025
Case Report
Georgi Lukose, Anna Mertelsmann, Rebecca M Marrero Rolon, David J Pisapia, Sanjay Patel, Christina Coyle, Lars F Westblade, Michael Satlin, Jamie Marino
Pathogen:Trypanosoma cruzi
Infection Type:Parasitic infection
Pathogen Type:Parasite

Summary

A patient with follicular lymphoma undergoing immunosuppression developed a fulminant and fatal reactivation of Trypanosoma cruzi. The clinical presentation involved severe, rapidly progressive symptoms. Diagnosis was confirmed by detecting high parasitemia, indicating an overwhelming parasitic burden. This case highlights the critical risk of Chagas disease reactivation in immunocompromised individuals, particularly those with underlying hematologic malignancies receiving chemotherapy. Early recognition and aggressive management are crucial, though often challenging in such severe presentations. The rapid progression and fatal outcome underscore the need for heightened awareness of opportunistic infections in this vulnerable population.

Key note: Immunosuppression in patients with lymphoma can lead to fulminant and fatal Trypanosoma cruzi reactivation, necessitating high clinical suspicion.

DOI: 10.1128/asmcr.00157-25