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Acute meningoencephalitis with subdural empyema associated with Acanthamoeba in an immunocompetent individual

Samik Pramanik1, Sugata Dasgupta1, Samarendranath Samui1

  • 1Department of Critical Care Medicine, IPGMER and SSKM Hospital, Kolkata, India.

The Journal of the Royal College of Physicians of Edinburgh
|May 19, 2025
PubMed

Insights

Acanthamoeba meningoencephalitis, a rare brain infection, can occur in healthy individuals. Early diagnosis and treatment, including surgical drainage and antimicrobials, led to complete recovery in this case.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Parasitology

Background:

  • Acanthamoeba meningoencephalitis is a rare but often fatal infection of the brain.
  • It can affect immunocompetent individuals, presenting diagnostic challenges.

Purpose of the Study:

  • To report a case of Acanthamoeba meningoencephalitis with subdural empyema in an immunocompetent patient.
  • To highlight the importance of early diagnosis and prompt intervention.

Main Methods:

  • Case report of a 50-year-old man with acute Acanthamoeba meningoencephalitis.
  • Diagnostic tools included neuroimaging and cerebrospinal fluid analysis.
  • Treatment involved burr-hole evacuation, antimicrobial therapy, and supportive care.

Main Results:

  • The patient presented with fever, neck stiffness, and hemiparesis.
  • Neuroimaging showed a subdural collection; CSF analysis revealed Acanthamoeba trophozoites.
  • Complete recovery was achieved within two weeks of hospitalization.

Conclusions:

  • Acanthamoeba should be considered in cases of meningoencephalitis, even in immunocompetent hosts.
  • Early diagnosis and timely intervention are crucial for favorable outcomes.
  • This case demonstrates successful management of a rare and severe infection.
Keywords:
Acanthamoebagranulomatous amoebic encephalitisimmunocompetentmeningoencephalitisprimary amoebic meningoencephalitis

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