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Fulminant amebic meningoencephalitis due to Acanthamoeba
Abstract:
A 57-year-old chronically immunosuppressed woman with systemic lupus erythematosus developed fulminant meningoencephalitis due to Acanthamoeba castellanii. Amebic trophozoites were also found in the lungs, suggesting a primary pulmonary focus of infection. This case illustrates that Acanthamoeba can cause a fulminant, rapidly fatal meningoencephalitis, as well as the previously reported chronic granulomatous meningoencephalitis. X
Insights
Acanthamoeba castellanii can cause a rapidly fatal brain infection (meningoencephalitis) in immunocompromised individuals. This case highlights a severe presentation, potentially originating from the lungs, in a patient with systemic lupus erythematosus.
Area of Science:
- Infectious Diseases
- Neurology
- Immunology
Background:
- Systemic lupus erythematosus (SLE) is an autoimmune disease that often requires chronic immunosuppression.
- Immunosuppression increases susceptibility to opportunistic infections.
- Acanthamoeba species are protozoa found in soil and water, known to cause infections.
Observation:
- A 57-year-old woman with a history of SLE and chronic immunosuppression presented with severe neurological symptoms.
- Fulminant meningoencephalitis was diagnosed.
- Acanthamoeba castellanii was identified as the causative agent.
- Amebic trophozoites were also detected in lung tissue.
Findings:
- The patient developed a rapidly progressive and fatal meningoencephalitis.
- The presence of Acanthamoeba in the lungs suggests a possible primary pulmonary infection site.
- This case demonstrates a fulminant, rapidly fatal form of Acanthamoeba meningoencephalitis, distinct from the chronic granulomatous form.
Implications:
- Acanthamoeba castellanii should be considered in the differential diagnosis of meningoencephalitis in immunosuppressed patients.
- Primary pulmonary infection may be a route for disseminated Acanthamoeba infection affecting the central nervous system.
- This case underscores the potential for severe, rapidly fatal outcomes from Acanthamoeba infections in immunocompromised hosts.