Granulomatous amebic encephalitis in a multivisceral transplant recipient

Area of Science:

• Neurology
• Infectious Diseases
• Transplantation Medicine

Background:

• Multivisceral allograft recipients are at increased risk for opportunistic infections.
• Central nervous system (CNS) infections can present with non-specific neurological symptoms.

Observation:

• A 40-year-old patient with a multivisceral allograft developed acute right-sided numbness.
• Initial investigations including cranial MRI, cerebrospinal fluid analysis, and stereotactic brain biopsy were non-diagnostic.
• The patient rapidly deteriorated, developing cerebral edema and succumbing to the illness.

Findings:

• Autopsy unexpectedly revealed Acanthamoeba encephalitis as the cause of the patient's demise.
• This diagnosis was missed during the patient's clinical course.

Implications:

• This case underscores the diagnostic difficulties in identifying amebic encephalitis in immunocompromised individuals.
• It expands the known spectrum of opportunistic CNS infections in solid and visceral organ transplant recipients.
• Highlights the need for heightened awareness and consideration of rare pathogens in transplant patients with neurological decline.