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Unexpected postmortem diagnosis of Acanthamoeba meningoencephalitis following allogeneic peripheral blood stem cell
J Pemán1, I Jarque, J Frasquet
1Servicio de Microbiología, Hospital Universitario La Fe, Valencia, Spain. peman_jav@gva.es
Abstract:
Meningoencephalitis caused by pathogenic free-living amebas is usually fatal. Only a few cases of Acanthamoeba meningoencephalitis, diagnosed at autopsy, have been reported following hematopoietic stem cell transplantation. We here report a case of Acanthamoeba meningoencephalitis following allogeneic peripheral blood stem cell transplantation with rapidly evolving neurologic symptoms that remained unexplained. Magnetic resonance imaging failed to show brain lesions and cerebrospinal fluid was negative for microbiological cultures. Definite diagnosis was an unexpected autopsy finding. As overall and teaching hospital autopsy rates are declining worldwide, we must emphasize the need of autopsy exams if we want to improve our knowledge as the best way to care for our patients.
Insights
A rare case of Acanthamoeba meningoencephalitis after stem cell transplant was diagnosed post-mortem. Autopsies are crucial for identifying fatal infections and improving patient care.
Area of Science:
- Neurology
- Infectious Diseases
- Transplantation Medicine
Background:
- Pathogenic free-living amebas, such as Acanthamoeba, can cause fatal meningoencephalitis.
- Acanthamoeba meningoencephalitis is rarely reported after hematopoietic stem cell transplantation (HSCT).
Observation:
- A patient developed rapidly progressing, unexplained neurologic symptoms post-allogeneic peripheral blood stem cell transplantation.
- Brain imaging (MRI) and cerebrospinal fluid cultures were inconclusive for diagnosis.
Findings:
- The definitive diagnosis of Acanthamoeba meningoencephalitis was an unexpected finding during autopsy.
- This highlights a potential, albeit rare, complication following HSCT.
Implications:
- Declining autopsy rates worldwide may hinder the identification of rare and fatal conditions.
- Emphasizing autopsy examinations is vital for advancing medical knowledge and patient care, especially in complex cases like post-transplant infections.
