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Published on: September 20, 2024
Acute granulomatous acanthamoeba encephalitis in an immunocompetent patient
Peter Lackner1, Ronny Beer, Gregor Broessner
1Department of Neurology, Innsbruck Medical University, 6020 Innsbruck, Anichstrasse 35, Austria, Europe. peter.lackner@i-med.ac.at
Background:
Acanthamoeba sp. are known to cause fatal granulomatous Acanthamoeba encephalitis (GAE) in immunocompromised patients.
Methods:
The case of a 17 year old immunocompetent patient with acute purulent meningoencephalitis is reported.
Results:
After substantial improvement of cerebrospinal fluid under conventional antimicrobial treatment the patient was suffering several relapses. The causative agent was identified as Acanthamoeba lenticulata T5 which entered the CNS through a bone dehiscence of ethmoidal cells. Due to severe vasospasm the patient developed multiple strokes, which led to marked neurologic sequels.
Conclusions:
This case report demonstrates successful treatment of usually lethal GAE in an immunocompetent patient with high dose meropenem, linezolid, moxifloxacin and fluconazole followed by a partially adapted antimicrobial combination therapy.
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