Fulminant acanthamoebic meningoencephalitis in immunocompetent patients: an uncommon entity
Lokesh Suresh Nehete1, Anil Kumar1, Pooja Chavali2
1Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India.
British Journal of Neurosurgery
|July 24, 2018
Abstract:
We are reporting two patients of fatal and rapidly progressive amoebic encephalitis in immunocompetent host from poor socioeconomic status. Both these patient had acute neurological worsening preoperatively and did not respond to subsequent surgical decompression. Biopsy report confirmed acanthamoebic cerebral infection.
Insights
We report two fatal cases of rapidly progressive amoebic encephalitis in immunocompetent individuals. Despite surgical intervention, both patients experienced acute neurological decline, with biopsies confirming acanthamoeba infection.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Acanthamoeba encephalitis is a rare and often fatal central nervous system infection.
- It primarily affects immunocompromised individuals, but cases in immunocompetent hosts are increasingly recognized.
- Socioeconomic factors may play a role in exposure and disease presentation.
Purpose of the Study:
- To report two cases of fatal amoebic encephalitis in immunocompetent patients from low socioeconomic backgrounds.
- To highlight the clinical presentation and diagnostic challenges of acanthamoeba cerebral infections.
- To emphasize the limited efficacy of surgical decompression in such cases.
Main Methods:
- Case report of two patients with severe neurological symptoms.
- Preoperative assessment and surgical decompression.
- Postoperative biopsy for histopathological and etiological confirmation.
Main Results:
- Both patients presented with rapidly progressive neurological deterioration.
- Neither patient responded to surgical decompression.
- Biopsy results confirmed acanthamoebic cerebral infection in both cases.
Conclusions:
- Acanthamoeba encephalitis can occur in immunocompetent individuals, particularly those from disadvantaged socioeconomic backgrounds.
- Rapid neurological decline and poor response to surgical treatment are characteristic.
- Early diagnosis and specific anti-amoebic therapy are crucial, though often challenging.
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