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Fulminant Acanthamoeba castellanii Encephalitis in an Ibrutinib-Treated Patient

Jessica W Crothers1, Liangge Hsu2, Francisco M Marty2

  • 1University of Vermont Medical Center, Burlington, Vermont, USA.

Open Forum Infectious Diseases
|February 15, 2020
PubMed

Insights

Fulminant Acanthamoeba encephalitis occurred in a patient with chronic lymphocytic leukemia receiving ibrutinib. This fatal case suggests ibrutinib

Area of Science:

  • Neuroscience
  • Immunology
  • Infectious Diseases

Background:

  • Acanthamoeba castellanii is an opportunistic pathogen.
  • Chronic lymphocytic leukemia (CLL) is a common hematologic malignancy.
  • Ibrutinib is a targeted therapy for CLL that inhibits Bruton tyrosine kinase (BTK).

Purpose of the Study:

  • To report a rare case of Acanthamoeba encephalitis in a CLL patient treated with ibrutinib.
  • To explore the potential role of ibrutinib in the pathogenesis of this infection.

Main Methods:

  • Case report.
  • Review of clinical presentation and treatment.
  • Discussion of potential immunologic mechanisms.

Main Results:

  • The patient experienced rapid neurologic decline and a fatal outcome.
  • The clinical course was unusually aggressive for Acanthamoeba encephalitis.

Conclusions:

  • Ibrutinib-induced inhibition of Bruton tyrosine kinase may impair immune responses against Acanthamoeba.
  • This case highlights a potential adverse effect of ibrutinib on host defense mechanisms.
  • Further research is needed to understand the immunomodulatory effects of ibrutinib in infectious diseases.
Keywords:
Acanthamoeba castellaniiNaegleriaamoebaencephalitisibrutinib

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