Central Nervous System Chagas Disease Reactivation in the Context of Heart Transplantation and Immunosuppression

A 48-year-old woman with a history of Chagas disease underwent heart transplantation and later developed neurologic decline. Imaging showed ring-enhancing lesions, and a brain biopsy confirmed central nervous system (CNS) reactivation of Trypanosoma cruzi . Treatment with benznidazole led to marked improvement. This case highlights the need to consider Chagas reactivation in immunosuppressed patients from endemic regions, emphasizing the importance of prompt imaging and diagnosis for effective management.