Abstract
BackgroundAcanthamoeba species can cause disseminating infections in immunocompromised individuals.Case presentationHere, we report a case of granulomatous acanthamoebic encephalitis with a lethal outcome in a 54-year-old German man who was human immunodeficiency virus-positive. The diagnosis was based on symptoms of progressive neurological deficits, including sensorimotor paralysis of his right leg and deteriorating alertness. Due to the rapid course and rather late diagnosis of the infection, effective treatment could not be applied and he died 12 days after hospital admission.ConclusionsTo the best of our knowledge, this is the second case of granulomatous acanthamoebic encephalitis reported within Germany. Our case highlights the importance of early diagnosis of granulomatous acanthamoebic encephalitis to prevent fatal outcome.
Highlights
Acanthamoeba species can cause disseminating infections in immunocompromised individuals
Acanthamoeba species are known as causal agents of disseminating infections in immunocompromised individuals (for example, human immunodeficiency virus (HIV) positive, immunosuppressive therapy), including granulomatous acanthamoebic encephalitis (GAE) [6–8]
Acanthamoeba species can cause so-called Acanthamoeba keratitis; Acanthamoeba keratitis mainly occurs in contact lens wearers and increasing casualties have been reported in the past decades [10, 11]
Summary
Acanthamoeba species are free-living amoeboid single-cell organisms that naturally occur in water and soil, but can be found in human-made habitats all over the world [1,2,3,4,5]. Acanthamoeba species are known as causal agents of disseminating infections in immunocompromised individuals (for example, human immunodeficiency virus (HIV) positive, immunosuppressive therapy), including granulomatous acanthamoebic encephalitis (GAE) [6–8]. Over a period of 5 days, progressive neurological deficits including sensorimotor paresis of his right leg and deterioration of alertness occurred. Viruses (except HIV-1), or bacteria were detected in blood and cerebrospinal fluid cultures nor in serologic tests and polymerase chain reaction (PCR; Table 1). Cysts of Acanthamoeba species were detected in periodic acid–Schiff (PAS) and Grocott stainings of brain specimens. Electroencephalography (EEG) on day 6 showed a lesion located in his left frontotemporal region with epileptic patterns in the left parietal lobe.
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