Acanthamoeba species from a post-covid patient with CSF rhinorrhea; a next possible post covid menace? A case report

Area of Science:

• Neurology
• Infectious Diseases
• Ophthalmology

Background:

• Acanthamoeba infections, particularly those affecting the central nervous system (CNS), are rare but serious conditions.
• There is a lack of standardized treatment protocols for amoebic meningoencephalitis, necessitating case-specific management strategies.
• Recent recovery from COVID-19, steroid therapy, and diabetes mellitus can compromise immunity, increasing susceptibility to opportunistic infections.

Observation:

• A 32-year-old female patient presented with Acanthamoeba rhinorrhea following a recent COVID-19 infection.
• The patient had a history of diabetes mellitus and had undergone steroid therapy, indicating a potentially immunocompromised state.
• The tertiary care institute in India managed the case without a pre-established protocol for this specific condition.

Findings:

• Successful management of Acanthamoeba rhinorrhea was achieved using a combination therapy of amphotericin B and miltefosine.
• Both amphotericin B and miltefosine possess trophicidal and cysticidal activities, crucial for eradicating Acanthamoeba.
• The patient's recovery suggests the efficacy of this combined therapeutic approach in CNS Acanthamoeba infections.

Implications:

• This case demonstrates a viable treatment option for CNS Acanthamoeba infections in immunocompromised individuals, including post-COVID-19 patients.
• Identifying contributing factors like COVID-19, steroid use, and diabetes is vital for risk assessment and prevention.
• Further research into standardized treatment protocols for Acanthamoeba infections affecting the CNS is warranted.