Cerebral amebiasis due to Acanthamoeba sp. in a patient with complete gp91 phox deficiency

Marie Roelens1,2,3, Anna-Lena Neehus2,4,5, Jérémie Rosain1,2,4,6

  • 1Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Journal of Human Immunity
|March 12, 2026
PubMed

Insights

Rare CYBB gene variants cause chronic granulomatous disease. A patient with cerebral abscesses and complete gp91 phox deficiency highlights the need for respiratory burst testing in children with deep abscesses.

Area of Science:

  • Immunology
  • Genetics
  • Infectious Diseases

Background:

  • Chronic granulomatous disease (CGD) is a primary immunodeficiency disorder.
  • CGD is caused by mutations in genes encoding components of the NADPH oxidase complex, primarily CYBB (gp91phox).
  • CYBB variants lead to impaired respiratory burst function in phagocytes.

Purpose of the Study:

  • To report a case of severe cerebral Acanthamoeba infection in a patient with complete gp91phox deficiency.
  • To highlight the diagnostic challenges and importance of respiratory burst evaluation in pediatric deep-seated abscesses.

Main Methods:

  • Case report of a pediatric patient.
  • Clinical presentation and diagnostic workup.
  • Microbiological identification of Acanthamoeba sp.

Main Results:

  • The patient presented with multiple cerebral abscesses.
  • Complete deficiency of gp91phox (CYBB) was confirmed.
  • Acanthamoeba sp. was identified as the causative pathogen.

Conclusions:

  • Complete gp91phox deficiency can predispose individuals to severe opportunistic infections, such as Acanthamoeba encephalitis.
  • Respiratory burst evaluation is crucial in the diagnostic workup of children presenting with deep abscesses, irrespective of suspected etiology.
  • Early diagnosis and management of CGD are essential to prevent severe infections.