Fulminant amebic meningoencephalitis due to Acanthamoeba

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.