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Cure of Acanthamoeba cerebral abscess in a liver transplant patient

Konrad Tang-Tat Fung1, Amar Paul Dhillon, James E McLaughlin

  • 1Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital, London, United Kingdom.

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|February 29, 2008
PubMed

Insights

Acanthamoeba infections causing brain abscess are fatal in transplant patients. This case shows successful treatment with antibiotics in a liver transplant recipient, offering hope for rare, severe infections.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Transplantation

Background:

  • Acanthamoeba infections causing cerebral abscess and encephalitis are rare, typically fatal, and often occur in immunocompromised individuals.
  • Literature review indicates a universally fatal outcome for Acanthamoeba infections in transplant recipients.
  • Diagnosis is frequently missed despite standard investigations like lumbar puncture, CT, and brain biopsy.

Observation:

  • This report details the first liver transplant patient diagnosed with an Acanthamoeba cerebral abscess.
  • The diagnosis was confirmed via brain tissue obtained during a decompressive frontal lobectomy.
  • The patient received a successful 3-month treatment regimen of co-trimoxazole and rifampicin.

Findings:

  • Successful treatment of Acanthamoeba cerebral abscess in a liver transplant patient is achievable.
  • Co-trimoxazole and rifampicin combination therapy proved effective.
  • Long-term follow-up showed no recurrence of the infection for 11 years.

Implications:

  • This case challenges the notion of universal fatality for Acanthamoeba brain infections in transplant patients.
  • Highlights the importance of considering Acanthamoeba in the differential diagnosis of CNS infections in immunocompromised hosts, especially transplant recipients.
  • Suggests that timely diagnosis and appropriate antimicrobial therapy can lead to favorable outcomes in previously uniformly fatal conditions.

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